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Ajrawat H, Buchholz J, Triana B, Pabon-Ramos W, Martin J, Kim C, Cline B, Ronald J. Abstract No. 583 Financial Analysis of Intravascular Ultrasound-Guided Transvenous Biopsy in an Outpatient Medicare Population. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Gallo C, Cline B, Befera N, Ronald J, Martin J, Sag A, Pabon-Ramos W, Suhocki P, Smith T, Kim C. Abstract No. 97 Safety and Patency of Dedicated Venous Stents for Treatment of Thoracic Central Vein Stenosis Compared with Non-Venous Stents. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Buchholz J, Ajrawat H, Cline B, Martin J, Kim C, Ronald J. Abstract No. 223 Intravascular Ultrasound-Guided Transvenous Biopsy of Retroperitoneal Lymph Nodes: Efficacy and Safety Compared with Percutaneous CT-Guided Biopsy. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Cheema B, Mutharasan RK, Sharma A, Jacobs M, Powers K, Lehrer S, Wehbe FH, Ronald J, Pifer L, Rich JD, Ghafourian K, Tibrewala A, McCarthy P, Luo Y, Pham DT, Wilcox JE, Ahmad FS. Augmented Intelligence to Identify Patients With Advanced Heart Failure in an Integrated Health System. JACC Adv 2022; 1:100123. [PMID: 36643021 PMCID: PMC9838119 DOI: 10.1016/j.jacadv.2022.100123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Timely referral for specialist evaluation in patients with advanced heart failure (HF) is a Class 1 recommendation. However, the transition from stage C HF to advanced or stage D HF often goes undetected in routine care, resulting in delayed referral and higher mortality rates. OBJECTIVES The authors sought to develop an augmented intelligence-enabled workflow using machine learning to identify patients with stage D HF and streamline referral. METHODS We extracted data on HF patients with encounters from January 1, 2007, to November 30, 2020, from a HF registry within a regional, integrated health system. We created an ensemble machine learning model to predict stage C or stage D HF and integrated the results within the electronic health record. RESULTS In a retrospective data set of 14,846 patients, the model had a good positive predictive value (60%) and low sensitivity (25%) for identifying stage D HF in a 100-person, physician-reviewed, holdout test set. During prospective implementation of the workflow from April 1, 2021, to February 15, 2022, 416 patients were reviewed by a clinical coordinator, with agreement between the model and the coordinator in 50.3% of stage D predictions. Twenty-four patients have been scheduled for evaluation in a HF clinic, 4 patients started an evaluation for advanced therapies, and 1 patient received a left ventricular assist device. CONCLUSIONS An augmented intelligence-enabled workflow was integrated into clinical operations to identify patients with advanced HF. Endeavors such as this require a multidisciplinary team with experience in design thinking, informatics, quality improvement, operations, and health information technology, as well as dedicated resources to monitor and improve performance over time.
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Affiliation(s)
- Baljash Cheema
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - R. Kannan Mutharasan
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Aditya Sharma
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Northwestern Medicine, Chicago, Illinois, USA
| | - Maia Jacobs
- Department of Computer Science, Northwestern University McCormick School of Engineering, Evanston, Illinois, USA
| | | | | | - Firas H. Wehbe
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | - Jonathan D. Rich
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kambiz Ghafourian
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anjan Tibrewala
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Patrick McCarthy
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yuan Luo
- Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Duc T. Pham
- Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jane E. Wilcox
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Faraz S. Ahmad
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA,Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Dai R, Kim C, Suhocki P, Martin J, Pabon-Ramos W, Sag A, Wildman-Tobriner B, Smith T, Ronald J. Abstract No. 27 Proton pump inhibitor use is associated with increased risk of post–transjugular intrahepatic portosystemic shunt hepatic encephalopathy: replication in an independent patient cohort. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Durocher N, Smith T, Gazda S, Olivas A, Whited K, Jones D, Langston M, Martin J, Kim C, Ronald J. 3:18 PM Abstract No. 220 A randomized controlled trial of metoclopramide versus placebo to reduce fluoroscopy time during gastrojejunostomy tube placement. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Li G, Pabon-Ramos W, Taylor J, Kim C, Ronald J, Suhocki P, Sag A, Smith T, Martin J. 3:45 PM Abstract No. 332 Financial impact of unbundling moderate sedation from procedural codes in radiology. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Taussig M, Ronald J, Seyferth E, Rao R, Perry W, Suhocki P, Smith T, Pabon-Ramos W, Kim C, Martin J. 4:21 PM Abstract No. 326 Use of covered stent-graft for transjugular intrahepatic portosystemic shunt placement reduces variceal rebleeding rate with or without variceal embolization. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Shropshire E, Pabon-Ramos W, Martin J, Ronald J, Suhocki P, Sag A, Smith T, Kim C. Abstract No. 477 Effectiveness of thoracic duct embolization using different embolic agents: glue and coils versus ethylene vinyl alcohol. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Perkins S, Ronald J, Li J, Xia X, Martin J, Sag A, Suhocki P, Kim C. 4:21 PM Abstract No. 31 Y90 radioembolization for hepatocellular carcinoma: impact of treatment distribution on hepatic function over time. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Martin J, Robinson C, Ronald J, Sag A, Suhocki P, Kim C. Abstract No. 564 Treatment of right-sided primary colon cancer metastatic to liver in current clinical practice. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Goldman D, Martin J, Carlon T, Liu L, Sag A, Ronald J, Patel R, Ranade M, Bishay V, Kim E, Nowakowski F, Lookstein R, Fischman A. Abstract No. 454 Crowd-sourced assessment of interventional radiology technical skill: a method to guide future training of interventional radiologists. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Li G, Pabon-Ramos W, Taylor J, Kim C, Ronald J, Suhocki P, Sag A, Smith T, Martin J. 3:18 PM Abstract No. 329 Delayed adoption of moderate sedation CPT code changes in interventional radiology: impact on revenue cycle and root cause analysis. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Li J, Ronald J, Sopko D, Kim C. 3:36 PM Abstract No. 95 Minimization of spinal cord ischemia after thoracoabdominal aortic aneurysm repair with coil embolization of intercostal/lumbar artery origin(s): initial experience. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Sag A, Sperduto W, Eward W, Ronald J, Davis H, Jiang S, Kim C. Abstract No. 492 Adjacent metallic instrumentation does not limit bone ablation when using a bipolar radiofrequency device. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Johnson D, Gallo C, Agassi A, Sag A, Martin J, Pabon-Ramos W, Ronald J, Suhocki P, Smith T, Kim C. Abstract No. 594 Percutaneous gastrojejunostomy tubes: identification of predictors of retrograde tip migration into the stomach. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Gatta L, Rodriguez I, Strickland K, Gilner J, Grotegut C, Ronald J, Bashir M, James A, Lee P, Secord A. Novel management of morbidly adherent placenta: Preliminary outcomes assessment of 13-year experience with prospective multidisciplinary algorithm. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pamarthi V, Kim C, Pabon-Ramos W, Martin J, Smith T, Ronald J, Suhocki P. 03:45 PM Abstract No. 243 Transcatheter endovascular therapy for delayed postoperative hemorrhage following pancreaticoduodenectomy. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zuchowski A, Cline B, Martin J, Ronald J, Kim C. 03:27 PM Abstract No. 356 Feasibility of HeRO graft insertion through stent interstices. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Ronald J, Nixon A, Hatch A, Brady J, Campa M, Devos N, Corcoran D, Hurwitz H, Martin J, Kim C. 04:03 PM Abstract No. 323 Transcatheter arterial embolization increases circulating cell-free DNA in patients with hepatocellular carcinoma. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Xia X, Perkins S, Ronald J, Suhocki P, Kim C. 03:36 PM Abstract No. 252 Impact of splenomegaly on survival after bland transarterial embolization for HCC. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Perkins S, Xia X, Li J, Suhocki P, Ronald J, Kim C. Abstract No. 528 Bland embolization versus radioembolization for the treatment of HCC in cirrhotic patients: propensity score analysis of the impact on hepatic function. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Befera N, Ronald J, Kim C, Smith T. 03:09 PM Abstract No. 404 Angiographic analysis of spinal arterial supply: when to worry and when not to worry during bronchial artery embolization. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Johnson D, Wang Q, Perkins S, Ronald J, Kim C. 3:00 PM Abstract No. 390 SBRT versus thermal ablation for treatment of hepatocellular carcinoma: impact on the MELD score in cirrhotic patients. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Lewis D, Suhocki P, Hall M, Smith T, Kim C, Ronald J. Abstract No. 627 Proton pump inhibitors are associated with increased risk of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Wang Q, Ronald J, Suhocki P, Kim C. 4:03 PM Abstract No. 188 Imaging predictors of radiologic response after bland transarterial embolization for hepatocellular carcinoma. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Gondalia R, Ronald J, Pabon-Ramos W, Suhocki P, Kim C. 3:18 PM Abstract No. 123 Is a “phase 1” planning angiogram prior to radioembolization necessary for arterial anatomic delineation? J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Ronald J, Wang Q, Choi S, Suhocki P, Hall M, Smith T, Kim C. Albumin-bilirubin grade versus MELD score for predicting survival after transjugular intrahepatic portosystemic shunt (TIPS) creation. Diagn Interv Imaging 2018; 99:163-168. [DOI: 10.1016/j.diii.2017.10.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/17/2017] [Accepted: 10/24/2017] [Indexed: 12/13/2022]
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Griffin AS, Preece SR, Ronald J, Smith TP, Suhocki PV, Kim CY. Hemorrhage risk with transjugular intrahepatic portosystemic shunt (TIPS) insertion at the main portal vein bifurcation with stent grafts. Diagn Interv Imaging 2017; 98:837-842. [PMID: 28843589 DOI: 10.1016/j.diii.2017.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to assess the incidence of major hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS) insertion using a stent graft at the main portal vein bifurcation. PATIENTS AND METHODS TIPS insertion using stent grafts was performed in 215 patients due to non-variceal hemorrhage indications. There were 137 men and 78 women, with a mean age of 57 years±10.6 (SD) (range: 19-90 years). Based on retrospective review of portal venograms, TIPS inserted within 5mm from the portal vein bifurcation were considered "bifurcation TIPS", while those inserted 2cm or greater from the bifurcation were considered intrahepatic. Suspicion for acute major periprocedural hemorrhage were categorized as low, moderate, and high, based on the number of signs of hemorrhage. RESULTS Of 215 TIPS inserted for purposes other than hemorrhage, the TIPS was inserted at the portal bifurcation in 41 patients (29 men, 12 women; mean age, 55.9±11.7 (SD); range: 26-79 years) and intrahepatic in 62 patients (37 men, 25 women; mean age, 57.6±10.6 (SD), range: 34-82 years), whereas 112 were indeterminate in location. No active extravasations were identified on post-TIPS portal venograms. Suspicion for acute major hemorrhage was moderate or high in 3/41 (7%) of patients in the TIPS bifurcation group compared to 5/62 (8%) in the intrahepatic TIPS group (P>0.99). There were no significant differences in 30-day mortality rates (1/41 [2%] and 3/62 [5%] respectively; P> 0.99). No deaths or interventions were attributed to acute hemorrhage. CONCLUSION TIPS insertion at the portal bifurcation with stent grafts did not incur an elevated risk of hemorrhagic complications.
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Affiliation(s)
- A S Griffin
- Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, 2311, Erwin Road, 27710 Durham, NC, United States
| | - S R Preece
- Vascular Institute, Teton Radiology, Idaho Falls, ID, United States
| | - J Ronald
- Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, 2311, Erwin Road, 27710 Durham, NC, United States
| | - T P Smith
- Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, 2311, Erwin Road, 27710 Durham, NC, United States
| | - P V Suhocki
- Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, 2311, Erwin Road, 27710 Durham, NC, United States
| | - C Y Kim
- Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, 2311, Erwin Road, 27710 Durham, NC, United States.
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Ronald J, Wang Q, Suhocki P, Hall M, Pabon-Ramos W, Sopko D, Smith T, Kim C. Comparison of albumin-bilirubin grade and Model for End-Stage Liver Disease score for predicting survival after transjugular intrahepatic portosystemic shunt creation. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Griffin A, Preece S, Ronald J, Suhocki P, Smith T, Kim C. Comparison of hemorrhagic complications and mortality for TIPS inserted via the intrahepatic versus extrahepatic portal venous system. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Ronald J, Ronald J, Davis B, Guevara C, Smith T, Kim C. Comparison of patency rates after angioplasty versus secondary stent deployment for treatment of in-stent restenoses of the central veins in hemodialysis patients. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hodavance M, Hall M, Ronald J, Pabon-Ramos W, Sopko D, Suhocki P, Kim C. Clinical predictors of pain after transarterial embolization of hepatocellular carcinoma. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kim C, Preece S, Lewis D, Ronald J, Smith T, Suhocki P. Impact of TIPS insertion on hepatic functional status. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Adetunji OR, Mani H, Olujohungbe A, Ronald J, Morgan C, Gill G. Prevalence and characteristics of anaemia in diabetes. ACTA ACUST UNITED AC 2008. [DOI: 10.1002/pdi.1223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Cook RJ, Ronald J, Pedley DK, Morrison WG. A nation divided. Arch Emerg Med 2006; 23:160. [PMID: 16439760 PMCID: PMC2564049 DOI: 10.1136/emj.2005.024448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Doherty DR, Sutcliffe IT, Shih J, Stanimirovic D, Suppes R, Gulati H, Halmarson E, Selaman M, Dellinger P, Kramer A, Roberts D, Kumar A, Ronald J, Gray M, Nenadovic V, Perez-Velazquez JL, Pang E, Barnes M, Otsubo H, Hutchison JS, Cheung C, Alibhai SMH, Robinson M, Chittock D, Drover J, Skrobik Y, Skrobik Y, Alibhai S, Grant EC, Menon K, Kusum M, Clinton TB, Jacka, Jacka M, Vera N. In collaboration with the canadian critical care society, the canadian journal of Anesthesia is proud to publish the best posters presented at the Toronto critical care medicine symposium 2004 (adult and pediatric) held in Toronto, Ontario, october 21-october 23, 2004. Can J Anaesth 2005. [DOI: 10.1007/bf03016303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ronald J, Delaive K, Roos L, Manfreda JH, Kryger MH. Obstructive sleep apnea patients use more health care resources ten years prior to diagnosis. Sleep Res Online 2001; 1:71-4. [PMID: 11382859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Because Obstructive Sleep Apnea Syndrome (OSAS) patients may be treated for comorbidities prior to OSAS diagnosis, we examined the health care utilization records of 181 OSAS patients and those of matched controls. We compared OSA patient health care utilization for a ten-year interval prior to diagnosis to those of randomized age-, gender-, and geographically-matched controls from the general population. We found that OSAS patients used approximately twice the resources (as defined by physician claims and stays in hospital) in the ten years prior to their diagnosis. Physician claims for cases totaled $686,365 ($3,972 per patient) compared to $356,376 ($1,969 per patient) for the controls for the length of the study. Utilization was significantly higher in 7 of 10 years prior to diagnosis. OSAS patients also had more hospitalizations: they had 1,118 nights (6.2 per patient) in hospital versus 676 nights (3.7 per patient) for controls over the ten-year period. Thus OSA patients are heavy users of health care resources ten years prior to diagnosis.
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Affiliation(s)
- J Ronald
- Sleep Disorders Center, St. Boniface General Hospital Research Center, Section of Respiratory Diseases, Department of Community Health Sciences and Department of Medicine, University of Manitoba, Winnipeg, Manitoba R2H 2A6, Canada
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Ertekin-Taner N, Graff-Radford N, Younkin LH, Eckman C, Baker M, Adamson J, Ronald J, Blangero J, Hutton M, Younkin SG. Linkage of plasma Abeta42 to a quantitative locus on chromosome 10 in late-onset Alzheimer's disease pedigrees. Science 2000; 290:2303-4. [PMID: 11125143 DOI: 10.1126/science.290.5500.2303] [Citation(s) in RCA: 292] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Plasma Abeta42 (amyloid beta42 peptide) is invariably elevated in early-onset familial Alzheimer's disease (AD), and it is also increased in the first-degree relatives of patients with typical late-onset AD (LOAD). To detect LOAD loci that increase Abeta42, we used plasma Abeta42 as a surrogate trait and performed linkage analysis on extended AD pedigrees identified through a LOAD patient with extremely high plasma Abeta. Here, we report linkage to chromosome 10 with a maximal lod score of 3.93 at 81 centimorgans close to D10S1225. Remarkably, linkage to the same region was obtained independently in a genome-wide screen of LOAD sibling pairs. These results provide strong evidence for a novel LOAD locus on chromosome 10 that acts to increase Abeta.
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Bahammam A, Delaive K, Ronald J, Manfreda J, Roos L, Kryger MH. Health care utilization in males with obstructive sleep apnea syndrome two years after diagnosis and treatment. Sleep 1999; 22:740-7. [PMID: 10505819 DOI: 10.1093/sleep/22.6.740] [Citation(s) in RCA: 176] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To document changes in health care utilization (physician claims and hospitalizations) two years after diagnosis and treatment of patients with OSAS. DESIGN Prospective observational cohort study. SETTING The study was done in the Canadian Province of Manitoba. OSAS patients were selected from a University-based sleep disorders center. Control subjects were selected from the general population. PATIENTS AND CONTROLS There were 344 OSAS patients on whom there was utilization data for the period of the study. They were matched to controls from the general population by gender, age, and geographic location. MEASUREMENTS AND RESULTS The difference in physician claims between the patients and their matched controls two years after diagnosis and treatment ($174+/-32.4 (SE) per year in Canadian dollars) was significantly less than the difference in the year before diagnosis ($260+/-35.7 (SE), p=0.038). Examining the subgroups of patients adhering (PAT) or not adhering (PNAT) to treatment revealed that the changes were only significant in the patients adhering to treatment. Hospital stays for the entire OSAS group decreased from 1.27 days+0.25(SE) per patient per year one year before diagnosis to 0.54+0.13 per patient per year (p=0.01). The changes in the PAT group (1.25+0.28 per patient per year one year before diagnosis to 0.53+0.14 per patient per year (p=0.034) were significant while in the PNAT group they were not. CONCLUSIONS Adherence to treatment in patients with OSAS results in a significant reduction in physician claims and hospital stays.
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Affiliation(s)
- A Bahammam
- Sleep Disorders Centre, St. Boniface General Hospital Research Centre, Department of Medicine, Winnipeg, Manitoba
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Ronald J, Delaive K, Roos L, Manfreda J, Bahammam A, Kryger MH. Health care utilization in the 10 years prior to diagnosis in obstructive sleep apnea syndrome patients. Sleep 1999; 22:225-9. [PMID: 10201067 DOI: 10.1093/sleep/22.2.225] [Citation(s) in RCA: 143] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) patients may have symptoms for years prior to recognition of their disorder, or they may be treated for the associated comorbidities. We hypothesized that such patients would be heavy consumers of health care resources for several years prior to diagnosis. We therefore compared health service utilization for a 10-year interval prior to diagnosis of 181 OSA patients to those of randomly selected age-, gender-, and geographically matched controls from the general population. OSAS patients used approximately twice as many health care services (as defined by physician claims and overnight stays in hospital) in the 10 years prior to their initial diagnostic evaluation for apnea. Physician claims for the OSA patients totaled $686,365 ($3972 per patient), compared to $356,376 ($1969 per patient) for the controls for the 10-year period examined in this study. Use of health services was significantly higher in 7 of 10 years prior to diagnosis. The OSAS patients also had more overnight hospitalizations: they spent 1118 nights (6.2 per patient) in hospital vs 676 nights (3.7 per patient) for controls in the decade prior to diagnosis. We conclude that by the time patients are finally diagnosed for sleep apnea, they have already been heavy users of health services for several years. It is possible that our findings reflect not OSAS per se, but the presence of some of the risk factors that predispose to OSAS, such as obesity, alcohol usage and perhaps tobacco consumption.
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Affiliation(s)
- J Ronald
- Sleep Disorders Centre, St. Boniface General Hospital Research Centre, Winnipeg, Manitoba, Canada
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Abstract
Experience of myoelectric prostheses for unilateral below-elbow amputees in a large region of Great Britain is presented. Of the cases considered, 14 were adults and 29 were 16 years of age or less. The rejection rate was 25% overall but it was lower in adults, at 17%. Comparisons with published data and other aspects of myoelectric prostheses are discussed. Just over half the 37 amputees interviewed were independent in activities of daily living; independence was more common in the adults, at 77%. A very large proportion of myoelectric prosthesis users also used body-powered prostheses, demonstrating a need for both types of prosthesis for optimum rehabilitation. It is recommended that myoelectric prosthetic programmes should be carried out from specialized centres with comprehensive facilities for this expensive rehabilitation aid.
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Affiliation(s)
- D Datta
- Nottingham Disablement Services Centre, City Hospital, UK
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Ronald J, Zaneveld V, Pak H. Method for the determination of the index of refraction of particles suspended in the ocean*. ACTA ACUST UNITED AC 1973. [DOI: 10.1364/josa.63.000321] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Abstract
Nine people from four families living in rural parts of Scotland have been found to suffer from clinical or biochemical effects of lead poisoning. Five had symptoms and four had unequivocal evidence of excessive lead exposure. The source of lead has been traced to the domestic water supply which in all cases was grossly contaminated with lead acquired from lead plumbing systems, including lead storage tanks. Clinical improvement followed the replacement of lead piping in two families studied. Lead poisoning is a possible cause of chronic ill health in areas of plumbosolvent water.
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Ronald J. Winter aches and pains. Practitioner 1968; 201:873-8. [PMID: 5708080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Ronald J. Hypernephroma and Polycythaemia. West J Med 1960. [DOI: 10.1136/bmj.2.5209.1384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ronald J. Hysterical Abdominal Proptosis. West J Med 1955. [DOI: 10.1136/bmj.2.4952.1390-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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