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Vasilopoulos T, Rawal S, Culley DJ, Fahy BG. Academic productivity and NIH funding for anesthesiology departmental chairs: A 15-year comparison. J Clin Anesth 2023; 91:111240. [PMID: 37660512 DOI: 10.1016/j.jclinane.2023.111240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/23/2023] [Revised: 07/28/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023]
Abstract
STUDY OBJECTIVE This study evaluated whether there were improvements in the number of departmental National Institutes of Health (NIH) training grants and the academic productivity of departmental chairs in terms of NIH research funding and PubMed-cited publications when compared to chairs of the same departments in 2006. DESIGN Each chair was identified from the Society of Academic Associations of Academic Anesthesiology & Perioperative Medicine's Association of Academic Anesthesiology Chairs and entered into the NIH Research Portfolio Online Reporting Tools (RePORTER), PubMed, SCOPUS, and the National Provider Identifier Registry. MEASUREMENTS The number and funding amounts of training grants awarded to the department in 2010, 2015, and 2020 were obtained as well as the department's national ranking and total dollar amount for NIH funding in 2020. For the current chair cohort, total publications and m-quotient (h-index corrected for active research years) were recorded along with each chair's history of NIH grant funding. These data were compared to a previous study of anesthesiology chairs that reviewed funding and publications through 2006. MAIN RESULTS We analyzed data from 100 academic departments of anesthesiology and compared their scholarly activity relative to data gathered in 2006. In 2020, 52 of 100 departments of anesthesiology had evidence of NIH funding. There were not statistically significant (P > 0.05) differences in grants funding obtained by chairs between 2006 and 2020 with the exception that more chairs in 2006 had program or center grants. Median publications for chairs significantly increased from 35 in 2006 to 55 in 2021 (IRR = 1.5, 95% CI = 1.2-2.0, P = 0.003). Nineteen percent of chairs were female, which did not significantly differ from the proportion of women in the 2006 paper (15%, χ2 = 0.57, df = 1, P = 0.452). Of the male chairs, 90% were professors whereas 63% of female chairs were professors (χ2 = 8.8, df = 1, P = 0.003). Female chairs had fewer publications than male chairs (IRR = 1.8, 95% CI = 1.2-1.8, P = 0.002); however, m-quotients were not significantly different between men and women (P = 0.602). CONCLUSIONS When compared to 2006, department of anesthesiology chairs had more publications in 2021; however, NIH funding rates remained unchanged. The specialty had 19% female chairs, and those chairs had fewer publications than their male counterparts, though sex differences were attenuated using metrics that account for disparities in career length.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610, USA; Department of Orthopaedics and Sports Medicine, University of Florida College of Medicine, PO Box 112727, Gainesville, FL 32611, USA
| | - Shiv Rawal
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610, USA
| | - Deborah J Culley
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Dulles 680, Philadelphia, PA 19104, USA
| | - Brenda G Fahy
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610, USA.
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Lindner O, Hacker M, Burchert W, Buechel RR. SPECT and PET myocardial perfusion imaging in Austria, Germany, and Switzerland results of the first joint survey of 2021. Eur J Nucl Med Mol Imaging 2023; 50:3602-3608. [PMID: 37452873 PMCID: PMC10547620 DOI: 10.1007/s00259-023-06336-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE This paper presents the results of the first joint survey on the use of SPECT and PET myocardial perfusion imaging (MPI) and cardiac amyloidosis imaging in Austria, Germany, and Switzerland of the year 2021. METHODS A questionnaire was sent in 2022 to centres practicing nuclear medicine. RESULTS Data from 14 Austrian (10,710 SPECT), 218 German (133,047 SPECT), and 16 Swiss centres (11,601 MPI (6,879 SPECT, 4722 PET)) were analysed. In Austria and Germany, the PET MPI numbers were close to zero and not considered. Official MPS numbers from 2015 to 2021 from Austria and Germany revealed a decline in Austria by about 40% in the pandemic years 2020 to 2021, but an increase in Germany by 9%. Ambulatory care cardiologists represented the major referral group (56-71%). Mostly, stress tests were performed pharmacologically (58-92%). Contrary to Germany, a 1-day protocol was predominant (58-97%) in Austria and Switzerland. The leading camera systems were SPECT-CT in Austria and Switzerland (57-79%) and multi-head systems in Germany (58%). Switzerland had the highest proportion of SPECT MPI with attenuation correction (84%), followed by Austria (43%), and Germany (33%). Electrocardiogram-gated SPECT MPI showed an overall high penetration of 87-99%. Scoring was most frequently applied in Germany (72%), followed by Austria (64%), and Switzerland (60%). Related to the population, the number of cardiac amyloidosis imaging was highest in Austria, followed by Switzerland and Germany. CONCLUSIONS This first joint survey of 2021 shows considerable differences among the countries. The Swiss situation is outstanding due to the wide use of PET MPI. In terms of camera equipment, Switzerland is also leading, followed by Austria and Germany. Despite the differences in procedural issues, the results reveal an overall high standard of MPI imaging.
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Affiliation(s)
- O Lindner
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Georgstr. 11, Bad Oeynhausen, Germany.
| | - M Hacker
- Klinische Abteilung für Nuklearmedizin, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Vienna, Austria
| | - W Burchert
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Georgstr. 11, Bad Oeynhausen, Germany
| | - R R Buechel
- Klinik für Nuklearmedizin, Universitätsspital Zürich, Zurich, Switzerland
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Artmann A, Rahn AC, Köpke S, Thomalla G, Heesen C, Alegiani AC. Risk communication in acute stroke patients - from qualitative data to a pilot randomised controlled trial. Z Evid Fortbild Qual Gesundhwes 2022; 169:19-27. [PMID: 35227636 DOI: 10.1016/j.zefq.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/11/2021] [Accepted: 01/02/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The probability of recurring strokes in patients with atrial fibrillation is high. Within 1.8 years, 6.6 % of the patients suffered a new stroke. While effective secondary prevention options exist, low adherence challenges effective medical treatment. The aim of our study was to examine the risk understanding of acute stroke patients and to find the best way to communicate risk reduction. MATERIALS AND METHODS Risk communication had three formats: a text, a pictogram, and a cube diagram. All three were developed on the basis of the criteria of evidence-based patient information. Patients who were admitted to the stroke unit and diagnosed with acute stroke, assessed the information material. Data on secondary prevention using acetylsalicylic acid were taken as an example, with no reference to actual patient treatment. In a first step, we interviewed a focus group to check the feasibility of the questionnaire (qualitative study). In the second step, the information material was tested in a pilot randomized controlled trial. RESULTS Acute stroke patients (qualitative study, n=13) understood the information and were interested in numerical risk communication. The visualized representations were superior in terms of understandability of the numbers communicated (pilot randomized controlled trial, n=60, 50 % correct answers for question 1, p value of 0.502, and 55 % correct answers for question 2, p value of 0.338). Stroke-related neurologic deficits, measured with the National Institute of Health Stroke Scale (NIHSS) on admission, revealed a significant influence on the number of correct answers to stroke risk questions, whereas the type of stroke and education did not. CONCLUSIONS Acute stroke patients were able to understand risk communication. Visualization helped them capture information on stroke risk.
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Affiliation(s)
- Anna Artmann
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| | - Anne Christin Rahn
- Institute of Social Medicine & Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
| | - Sascha Köpke
- Institute of Social Medicine & Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Heesen
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Institut for Neuroimmunology und Multiple Sklerosis, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Christina Alegiani
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Asklepsios Klinik Altona, Hamburg, Germany
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Adana F, Durmaz S, Özvurmaz S, Akpınar CV, Yeşilfidan D. Descriptors of living alone for elders: based on Turkey national data. BMC Geriatr 2022; 22:37. [PMID: 35012469 PMCID: PMC8750866 DOI: 10.1186/s12877-021-02706-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background The objective of this study is to analyze the data of the 2018 Turkey Demographic and Health Survey and determine personal and demographic factors associated with elderly who are 60 and older and living alone. Methods This cross-sectional study is the secondary analysis of the national data obtained with the 2018 Turkey Demographic and Health Survey. Logistic regression analysis was used to estimate differences in living alone based on gender, age, welfare status, region of residence, urban/rural residence, whether the person is working in a paid job and home ownership. Independent effect of every variable is observed in the first stage and then checked for all variables in the equation. Results There is a total of 37,897 participants’ data in the Turkey Demographic and Health Survey Database. In the study, there are 6244 (16.5%) older adults in 11,056 households and 9.79% of the elderly population is alone. The percentage of elderly women living alone is 13.62% while this percentage is 5.48% for elderly men (p < 0.001). The risk of living alone for elderly women is 2.74 times more than elderly men (95% Cl 2.28–3.31). Being poor increases the risk of living alone for elderly people 2.84 fold compared to being rich (95% Cl 2.17–3.71). Those who have high school and higher education level have 2.38 (95% Cl 1.73–3.29) fold higher risk of living alone than people with lower education. Older adults living in the Western region of the country have 3.18 (95% Cl 2.20–4.59) times higher risk of living alone than older adults living in the Eastern region of the country. The risk of living alone for older adults increases 1.90 fold (95% Cl 1.55–2.32) if the house they live in do not belong to a household member. Conclusion Based on these findings, needs of older adults under risk should be met to allow them to be healthy and live their lives in better social, economic and cultural conditions.
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Affiliation(s)
- Filiz Adana
- Faculty of Nursing, Department of Public Health Nursing, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Seyfi Durmaz
- Faculty of Medicine, Department of Public Health, Ege University, İzmir, Turkey
| | - Safiye Özvurmaz
- Faculty of Nursing, Department of Public Health Nursing, Aydın Adnan Menderes University, Aydın, Turkey
| | - Ceren Varer Akpınar
- Faculty of Medicine, Department of Public Health, Giresun University, Giresun, Turkey
| | - Duygu Yeşilfidan
- Faculty of Nursing, Department of Public Health Nursing, Aydın Adnan Menderes University, Aydın, Turkey
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Cai T, Zhang L, Yang N, Kumamaru KK, Rybicki FJ, Cai T, Liao KP. EXTraction of EMR numerical data: an efficient and generalizable tool to EXTEND clinical research. BMC Med Inform Decis Mak 2019; 19:226. [PMID: 31730484 PMCID: PMC6858776 DOI: 10.1186/s12911-019-0970-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 11/06/2019] [Indexed: 11/12/2022] Open
Abstract
Background Electronic medical records (EMR) contain numerical data important for clinical outcomes research, such as vital signs and cardiac ejection fractions (EF), which tend to be embedded in narrative clinical notes. In current practice, this data is often manually extracted for use in research studies. However, due to the large volume of notes in datasets, manually extracting numerical data often becomes infeasible. The objective of this study is to develop and validate a natural language processing (NLP) tool that can efficiently extract numerical clinical data from narrative notes. Results To validate the accuracy of the tool EXTraction of EMR Numerical Data (EXTEND), we developed a reference standard by manually extracting vital signs from 285 notes, EF values from 300 notes, glycated hemoglobin (HbA1C), and serum creatinine from 890 notes. For each parameter of interest, we calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and F1 score of EXTEND using two metrics. (1) completion of data extraction, and (2) accuracy of data extraction compared to the actual values in the note verified by chart review. At the note level, extraction by EXTEND was considered correct only if it accurately detected and extracted all values of interest in a note. Using manually-annotated labels as the gold standard, the note-level accuracy of EXTEND in capturing the numerical vital sign values, EF, HbA1C and creatinine ranged from 0.88 to 0.95 for sensitivity, 0.95 to 1.0 for specificity, 0.95 to 1.0 for PPV, 0.89 to 0.99 for NPV, and 0.92 to 0.96 in F1 scores. Compared to the actual value level, the sensitivity, PPV, and F1 score of EXTEND ranged from 0.91 to 0.95, 0.95 to 1.0 and 0.95 to 0.96. Conclusions EXTEND is an efficient, flexible tool that uses knowledge-based rules to extract clinical numerical parameters with high accuracy. By increasing dictionary terms and developing new rules, the usage of EXTEND can easily be expanded to extract additional numerical data important in clinical outcomes research.
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Affiliation(s)
- Tianrun Cai
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, 6016BB, 60 Fenwood Road, Boston, 02115, USA. .,Harvard Medical School, Boston, MA, USA.
| | | | - Nicole Yang
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, 6016BB, 60 Fenwood Road, Boston, 02115, USA
| | - Kanako K Kumamaru
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Frank J Rybicki
- Department of Radiology, University of Ottawa, Ottawa, Canada
| | - Tianxi Cai
- Harvard Medical School, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katherine P Liao
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, MA, 6016BB, 60 Fenwood Road, Boston, 02115, USA.,Harvard Medical School, Boston, MA, USA.,VA Boston Healthcare System, Boston, MA, USA
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Nascimento DP, Gonzalez GZ, Araujo AC, Costa LOP. Description of low back pain clinical trials in physical therapy: a cross sectional study. Braz J Phys Ther 2019; 23:448-57. [PMID: 30237058 DOI: 10.1016/j.bjpt.2018.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/27/2018] [Accepted: 09/04/2018] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To describe the main characteristics of low back pain randomized controlled trials on the Physiotherapy Evidence Database, and to rank the journals where these trials were published according to their Impact Factor. METHODS This is a cross sectional study based on a collection of randomized controlled trials. A random sample of 200 low back pain trials published between 2010 and 2015 were selected from Physiotherapy Evidence Database in February 2016. We collected the following main characteristics of trials: 2015 journal Impact Factor; if the paper was published as open access; CONSORT recommendations endorsement by the journal; methodological quality and statistical reporting measured by the 0-10 items Physiotherapy Evidence Database scale. Data was analyzed descriptively. RESULTS Trials were published in journals with a mean Impact Factor of 2.5 (SD 2.5), from which 55.5% endorsed the CONSORT recommendations. The methodological quality was moderate with 5.8 points (SD 1.6). The top 3 journals according to Impact Factor were: (1) British Medical Journal; (2) Annals of Internal Medicine; and (3) BMC Medicine. Only 6 out of 97 journals publishing low back pain trials combined the following factors: journal Impact Factor higher than 2.0, mean trial methodological quality higher than 6.0 points, endorse CONSORT recommendations and offering papers as open access. CONCLUSION Clinicians interested in low back pain trials must look for a wide variety of healthcare journals. A substantial number of low back pain randomized controlled trials did not follow adequate reporting and methodological recommendations.
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Boyce JM. Electronic monitoring in combination with direct observation as a means to significantly improve hand hygiene compliance. Am J Infect Control 2017; 45:528-35. [PMID: 28456322 DOI: 10.1016/j.ajic.2016.11.029] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/26/2016] [Accepted: 11/27/2016] [Indexed: 01/16/2023]
Abstract
Monitoring hand hygiene compliance among health care personnel (HCP) is an essential element of hand hygiene promotion programs. Observation by trained auditors is considered the gold standard method for establishing hand hygiene compliance rates. Advantages of observational surveys include the unique ability to establish compliance with all of the World Health Organization "My 5 Moments for Hand Hygiene" initiative Moments and to provide just-in-time coaching. Disadvantages include the resources required for observational surveys, insufficient sample sizes, and nonstandardized methods of conducting observations. Electronic and camera-based systems can monitor hand hygiene performance on all work shifts without a Hawthorne effect and provide significantly more data regarding hand hygiene performance. Disadvantages include the cost of installation, variable accuracy in estimating compliance rates, issues related to acceptance by HCP, insufficient data regarding their cost-effectiveness and influence on health care-related infection rates, and the ability of most systems to monitor only surrogates for Moments 1, 4, and 5. Increasing evidence suggests that monitoring only Moments 1, 4, and 5 provides reasonable estimates of compliance with all 5 Moments. With continued improvement of electronic monitoring systems, combining electronic monitoring with observational methods may provide the best information as part of a multimodal strategy to improve and sustain hand hygiene compliance rates among HCP.
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Fujibayashi K, Hayashi M, Yokokawa H, Naito T. Changes in antidiabetic prescription patterns and indicators of diabetic control among 200,000 patients over 13 years at a single institution in Japan. Diabetol Metab Syndr 2016; 8:72. [PMID: 27843494 PMCID: PMC5103499 DOI: 10.1186/s13098-016-0187-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/04/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND We examined the long-term changes in the management of diabetes at a single institution in Japan. METHODS Two repeated cross-sectional studies and a retrospective cohort study were conducted among patients who visited our institution between 2001 and 2013. We examined the changes in glycated hemoglobin (HbA1c) and glycated albumin levels, the prescription frequencies, and the daily doses of each antidiabetic agent among patients treated regularly for diabetes during the 13-year study period. The trends in control and treatment parameters were analyzed using Spearman's rank correlation coefficient. RESULTS In the first repeated cross-sectional studies, 200,298 patients had their glucose metabolism indicators measured, and diabetologists prescribed medications to 193, 445 patients. Of these, 170 patients were included in the retrospective cohort study. The patients' diabetic control tended to improve over the study period. The mean HbA1c level improved from 7.9 to 7.6% (from 63 to 60 mmol/mol) (rs = -0.11, p < 0.01) in the cross-sectional study, corresponding to a change from 8.2 to 7.7% (from 66 to 61 mmol/mol) (rs = -0.22, p < 0.01) in the retrospective study. The mean GA level improved from 22.7 to 20.7% (rs = -0.13, p < 0.01) in the cross-sectional study and from 23.5 to 21.5% (rs = -0.14, p < 0.01) in the retrospective study. Over the study period, prescription frequencies and daily doses of antidiabetic agents changed as treatment guidelines were altered. CONCLUSIONS The present study revealed a tendency toward long-term improvements in diabetic control, with changes in the prescription patterns consistent with research and guideline evidence.
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Affiliation(s)
- Kazutoshi Fujibayashi
- Department of General Medicine, School of Medicine, Juntendo University, 3-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421 Japan
| | - Michio Hayashi
- Endocrinology and Metabolism Division, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625 Japan
| | - Hirohide Yokokawa
- Department of General Medicine, School of Medicine, Juntendo University, 3-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421 Japan
| | - Toshio Naito
- Department of General Medicine, School of Medicine, Juntendo University, 3-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421 Japan
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Abstract
The identification of similar entities represented by records in different databases has drawn considerable attention in many application areas, including in the health domain. One important type of entity matching application that is vital for quality healthcare analytics is the identification of similar patients, known as similar patient matching. A key component of identifying similar records is the calculation of similarity of the values in attributes (fields) between these records. Due to increasing privacy and confidentiality concerns, using the actual attribute values of patient records to identify similar records across different organizations is becoming non-trivial because the attributes in such records often contain highly sensitive information such as personal and medical details of patients. Therefore, the matching needs to be based on masked (encoded) values while being effective and efficient to allow matching of large databases. Bloom filter encoding has widely been used as an efficient masking technique for privacy-preserving matching of string and categorical values. However, no work on Bloom filter-based masking of numerical data, such as integer (e.g. age), floating point (e.g. body mass index), and modulus (numbers wrap around upon reaching a certain value, e.g. date and time), which are commonly required in the health domain, has been presented in the literature. We propose a framework with novel methods for masking numerical data using Bloom filters, thereby facilitating the calculation of similarities between records. We conduct an empirical study on publicly available real-world datasets which shows that our framework provides efficient masking and achieves similar matching accuracy compared to the matching of actual unencoded patient records.
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Affiliation(s)
- Dinusha Vatsalan
- Research School of Computer Science, The Australian National University, Canberra, ACT 2601, Australia.
| | - Peter Christen
- Research School of Computer Science, The Australian National University, Canberra, ACT 2601, Australia.
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Parriott AM, Brown JM, Arah OA. Hospital and provider patient volumes, cesarean section rates, and early postpartum invasive methicillin-resistant Staphylococcus aureus infection. Am J Infect Control 2014; 42:156-9. [PMID: 24360642 DOI: 10.1016/j.ajic.2013.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 08/05/2013] [Accepted: 08/19/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We sought to examine whether hospital and provider volumes and cesarean section rates influenced early postpartum invasive methicillin-resistant Staphylococcus aureus (MRSA) infection. METHODS We used data from the Nationwide Inpatient Sample, a representative sample of US community hospitals. Multivariate hierarchical regression models were used to estimate odds ratios adjusted for hospital total discharges, nurse:patient ratio, urbanicity, teaching status, bed size, ownership, and geographic region and patient age, race, expected payer, and comorbidities. RESULTS The total sample size for the hospital analysis was 3,487,350 deliveries, which included 555 cases of MRSA infection. The total sample size for the provider analysis was 1,186,703 deliveries, with 221 cases of MRSA infection. Hospital and provider patient (deliveries) volumes and cesarean section rates were not associated with early postpartum invasive MRSA infection. CONCLUSIONS Barring major bias in our estimates, our results suggest that transmission from providers may not be a predominant route of postpartum MRSA infection in US hospitals.
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