Scholars@Duke
Bibhas Chakraborty

Bibhas Chakraborty

Adjunct Associate Professor in the Department of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Biostatistics

Selected Publications

Enhancing Team Science by Training Collaborative Biostatisticians to have a Strong Statistical Voice.

Journal Article J Stat Theory Pract · 2026 Strong statistical voice is defined as the ability to advocate and negotiate for good and ethical statistical practices, including integrating and resolving differing scientific approaches. This skill is crucial for biostatisticians who work on biomedical ... Full text Link to item Cite

A social determinants-based county-level cardiovascular mortality index to identify high-risk counties in the USA.

Journal Article BMC Med · December 2, 2025 BACKGROUND: Social determinants of health (SDOH) contribute significantly to geographical variations in cardiovascular disease (CVD) mortality in the USA. We aimed to develop and evaluate a SDOH-related social cardiovascular mortality index (SCMI) as a pop ... Full text Link to item Cite

Reinforcement Learning in Modern Biostatistics: Constructing Optimal Adaptive Interventions

Journal Article International Statistical Review · December 1, 2025 In recent years, reinforcement learning (RL) has acquired a prominent position in health-related sequential decision-making problems, gaining traction as a valuable tool for delivering adaptive interventions (AIs). However, in part due to a poor synergy be ... Full text Cite

Developing federated time-to-event scores using heterogeneous real-world survival data.

Journal Article Comput Biol Med · October 2025 OBJECTIVE: Survival analysis serves as a fundamental component in numerous healthcare applications, where the determination of the time to specific events (such as the onset of a certain disease or death) for patients is crucial for clinical decision-makin ... Full text Link to item Cite

Skew-probabilistic neural networks for learning from imbalanced data

Journal Article Pattern Recognition · September 1, 2025 Real-world datasets often exhibit imbalanced data distribution, where certain class levels are severely underrepresented. In such cases, traditional pattern classifiers have shown a bias towards the majority class, impeding accurate predictions for the min ... Full text Cite

A Randomized Trial Using an Online Grocery Store to Evaluate a Multicomponent Digital Intervention to Improve Diet Quality.

Journal Article Am J Prev Med · July 2025 INTRODUCTION: Poor diet is a key contributor to rising rates of noncommunicable diseases. This study tested the ability of an online grocery store that includes a multicomponent digital intervention identified through the Multiphase Optimization Strategy t ... Full text Link to item Cite

Screening for depressive disorders: Validation of the Patient Health Questionnaire for Adolescents (PHQ-A) in a population-based multi-ethnic Asian sample.

Journal Article Psychiatry Res · June 2025 OBJECTIVE: To validate the Patient Health Questionnaire for Adolescents (PHQ-A) as a screening tool for depressive disorders in multi-ethnic Asian adolescents. METHODS: 323 English-speaking Singaporean adolescents completed the PHQ-A, Kiddie Schedule for A ... Full text Link to item Cite

THOMPSON SAMPLING FOR ZERO-INFLATED COUNT OUTCOMES WITH AN APPLICATION TO THE DRINK LESS MOBILE HEALTH STUDY

Journal Article Annals of Applied Statistics · June 1, 2025 Mobile health (mHealth) interventions often aim to improve distal out-comes, such as clinical conditions, by optimizing proximal outcomes through just-in-time adaptive interventions. Contextual bandits provide a suitable framework for customizing such inte ... Full text Cite

Bridging Innovation and Equity: Advancing Public Health Through Just-in-Time Adaptive Interventions.

Journal Article Annu Rev Public Health · April 2025 This review explores the transformative potential of just-in-time adaptive interventions (JITAIs) as a scalable solution for addressing health disparities in underserved populations. JITAIs, delivered via mobile health technologies, could provide personali ... Full text Link to item Cite

Digital solution for salutogenic brain health: a pilot sequential multiple assignment randomised trial (SMART) protocol for clinical implementation.

Journal Article BMJ Open · March 25, 2025 INTRODUCTION: Middle-aged adults with chronic conditions including diabetes, hyperlipidaemia and hypertension are at higher risk for cognitive decline. However, there is a lack of a targeted solution for this population. This study aims to develop a digita ... Full text Link to item Cite

The LvL UP trial: Protocol for a sequential, multiple assignment, randomised controlled trial to assess the effectiveness of a blended mobile lifestyle intervention.

Journal Article Contemp Clin Trials · March 2025 BACKGROUND: Blended mobile health (mHealth) interventions - combining self-guided and human support components - could play a major role in preventing non-communicable diseases (NCDs) and common mental disorders (CMDs). This protocol describes a sequential ... Full text Link to item Cite

Causal inference from observational data in neurosurgical studies: a mini-review and tutorial.

Journal Article Acta Neurochir (Wien) · February 12, 2025 BACKGROUND: Establishing a causation relationship between treatments and patient outcomes is of essential importance for researchers to guide clinical decision-making with rigorous scientific evidence. Despite the fact that randomized controlled trials are ... Full text Link to item Cite

A Penalized Shared-Parameter Algorithm for Estimating Optimal Dynamic Treatment Regimens

Journal Article Statistics in Biosciences · January 1, 2025 A dynamic treatment regimen (DTR) is a set of decision rules to personalize treatments for an individual using their medical history. The Q-learning-based Q-shared algorithm has been used to develop DTRs that involve decision rules shared across multiple s ... Full text Cite

A modified and weighted Gower distance-based clustering analysis for mixed type data: a simulation and empirical analyses.

Journal Article BMC Med Res Methodol · December 18, 2024 BACKGROUND: Traditional clustering techniques are typically restricted to either continuous or categorical variables. However, most real-world clinical data are mixed type. This study aims to introduce a clustering technique specifically designed for datas ... Full text Link to item Cite

FAIM: Fairness-aware interpretable modeling for trustworthy machine learning in healthcare.

Journal Article Patterns (N Y) · October 11, 2024 The escalating integration of machine learning in high-stakes fields such as healthcare raises substantial concerns about model fairness. We propose an interpretable framework, fairness-aware interpretable modeling (FAIM), to improve model fairness without ... Full text Link to item Cite

Effectiveness of a Digital Health Intervention Leveraging Reinforcement Learning: Results From the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) Randomized Clinical Trial.

Journal Article J Med Internet Res · October 8, 2024 BACKGROUND: Digital and mobile health interventions using personalization via reinforcement learning algorithms have the potential to reach large number of people to support physical activity and help manage diabetes and depression in daily life. OBJECTIVE ... Full text Link to item Cite

Optimal adaptive SMART designs with binary outcomes.

Journal Article Biometrics · October 3, 2024 In a sequential multiple-assignment randomized trial (SMART), a sequence of treatments is given to a patient over multiple stages. In each stage, randomization may be done to allocate patients to different treatment groups. Even though SMART designs are ge ... Full text Link to item Cite

A framework for testing non-inferiority in a three-arm, sequential, multiple assignment randomized trial.

Journal Article Stat Methods Med Res · April 2024 Sequential multiple assignment randomized trial design is becoming increasingly used in the field of precision medicine. This design allows comparisons of sequences of adaptive interventions tailored to the individual patient. Superiority testing is usuall ... Full text Link to item Cite

Incorporating nonparametric methods for estimating causal excursion effects in mobile health with zero-inflated count outcomes.

Journal Article Biometrics · March 27, 2024 In mobile health, tailoring interventions for real-time delivery is of paramount importance. Micro-randomized trials have emerged as the "gold-standard" methodology for developing such interventions. Analyzing data from these trials provides insights into ... Full text Link to item Cite

Extending the diabetic retinopathy screening intervals in Singapore: methodology and preliminary findings of a cohort study.

Journal Article BMC Public Health · March 13, 2024 BACKGROUND: The Diabetic Retinopathy Extended Screening Study (DRESS) aims to develop and validate a new DR/diabetic macular edema (DME) risk stratification model in patients with Type 2 diabetes (DM) to identify low-risk groups who can be safely assigned ... Full text Link to item Cite

The effect of cognitive behavioral therapy text messages on mood: A micro-randomized trial.

Journal Article PLOS Digit Health · February 2024 The StayWell at Home intervention, a 60-day text-messaging program based on Cognitive Behavioral Therapy (CBT) principles, was developed to help adults cope with the adverse effects of the global pandemic. Participants in StayWell at Home were found to sho ... Full text Link to item Cite

Incorporating participants' welfare into sequential multiple assignment randomized trials.

Journal Article Biometrics · January 29, 2024 Dynamic treatment regimes (DTRs) are sequences of decision rules that recommend treatments based on patients' time-varying clinical conditions. The sequential, multiple assignment, randomized trial (SMART) is an experimental design that can provide high-qu ... Full text Link to item Cite

Workshop on Algorithmic Behavior Change Support

Conference Ceur Workshop Proceedings · January 1, 2024 To increase the effectiveness of behavior change applications, a large variety of algorithms has been developed to adapt what the applications offer, when, how, and with whom. Given the multitude of challenges related to the concept of algorithmic behavior ... Cite

Federated and distributed learning applications for electronic health records and structured medical data: a scoping review.

Journal Article J Am Med Inform Assoc · November 17, 2023 OBJECTIVES: Federated learning (FL) has gained popularity in clinical research in recent years to facilitate privacy-preserving collaboration. Structured data, one of the most prevalent forms of clinical data, has experienced significant growth in volume c ... Full text Link to item Cite

iVY: protocol for a randomised clinical trial to test the effect of a technology-based intervention to improve virological suppression among young adults with HIV in the USA.

Journal Article BMJ Open · October 6, 2023 INTRODUCTION: Young adults with HIV (YWH) experience worse clinical outcomes than adults and have high rates of substance use (SU) and mental illness that impact their engagement in care and adherence to antiretroviral therapy (ART). The intervention for V ... Full text Link to item Cite

Testing the Effects of App-Based Motivational Messages on Physical Activity and Resting Heart Rate Through Smartphone App Compliance in Patients With Vulnerable Coronary Artery Plaques: Protocol for a Microrandomized Trial.

Journal Article JMIR Res Protoc · October 2, 2023 BACKGROUND: Achieving the weekly physical activity recommendations of at least 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic exercise is important for reducing cardiometabolic risk, but evidence shows that most peopl ... Full text Link to item Cite

FedScore: A privacy-preserving framework for federated scoring system development.

Journal Article J Biomed Inform · October 2023 OBJECTIVE: We propose FedScore, a privacy-preserving federated learning framework for scoring system generation across multiple sites to facilitate cross-institutional collaborations. MATERIALS AND METHODS: The FedScore framework includes five modules: fed ... Full text Link to item Cite

A flexible micro-randomized trial design and sample size considerations.

Journal Article Stat Methods Med Res · September 2023 Technological advancements have made it possible to deliver mobile health interventions to individuals. A novel framework that has emerged from such advancements is the just-in-time adaptive intervention, which aims to suggest the right support to the indi ... Full text Link to item Cite

Handling missing values in healthcare data: A systematic review of deep learning-based imputation techniques.

Journal Article Artif Intell Med · August 2023 OBJECTIVE: The proper handling of missing values is critical to delivering reliable estimates and decisions, especially in high-stakes fields such as clinical research. In response to the increasing diversity and complexity of data, many researchers have d ... Full text Link to item Cite

Sample size estimation for comparing dynamic treatment regimens in a SMART: A Monte Carlo-based approach and case study with longitudinal overdispersed count outcomes.

Journal Article Stat Methods Med Res · July 2023 Dynamic treatment regimens (DTRs), also known as treatment algorithms or adaptive interventions, play an increasingly important role in many health domains. DTRs are motivated to address the unique and changing needs of individuals by delivering the type o ... Full text Link to item Cite

Participant Engagement in Microrandomized Trials of mHealth Interventions: Scoping Review.

Journal Article JMIR Mhealth Uhealth · May 22, 2023 BACKGROUND: Microrandomized trials (MRTs) have emerged as the gold standard for the development and evaluation of multicomponent, adaptive mobile health (mHealth) interventions. However, not much is known about the state of participant engagement measureme ... Full text Link to item Cite

A universal AutoScore framework to develop interpretable scoring systems for predicting common types of clinical outcomes.

Journal Article STAR Protoc · May 12, 2023 The AutoScore framework can automatically generate data-driven clinical scores in various clinical applications. Here, we present a protocol for developing clinical scoring systems for binary, survival, and ordinal outcomes using the open-source AutoScore ... Full text Link to item Cite

A novel approach to assess dynamic treatment regimes embedded in a SMART with an ordinal outcome.

Journal Article Stat Med · March 30, 2023 Sequential multiple assignment randomized trials (SMARTs) are used to construct data-driven optimal intervention strategies for subjects based on their intervention and covariate histories in different branches of health and behavioral sciences where a seq ... Full text Link to item Cite

A distribution-free smoothed combination method to improve discrimination accuracy in multi-category classification.

Journal Article Stat Methods Med Res · February 2023 Results from multiple diagnostic tests are combined in many ways to improve the overall diagnostic accuracy. For binary classification, maximization of the empirical estimate of the area under the receiver operating characteristic curve has widely been use ... Full text Link to item Cite

Microrandomized Trials: Developing Just-in-Time Adaptive Interventions for Better Public Health.

Journal Article Am J Public Health · January 2023 Just-in-time adaptive interventions (JITAIs) represent an intervention design that adapts the provision and type of support over time to an individual's changing status and contexts, intending to deliver the right support on the right occasion. As a novel ... Full text Link to item Cite

The Sequential Multiple Assignment Randomized Trial for Controlling Infectious Diseases: A Review of Recent Developments.

Journal Article Am J Public Health · January 2023 Infectious diseases have posed severe threats to public health across the world. Effective prevention and control of infectious diseases in the long term requires adapting interventions based on epidemiological evidence. The sequential multiple assignment ... Full text Link to item Cite

A study of the impact of policy interventions on daily COVID scenario in India using interrupted time series analysis

Journal Article Epidemiologic Methods · January 1, 2023 Objectives: The rapid increase both in daily cases and daily deaths made the second wave of COVID-19 pandemic in India more lethal than the first wave. Record number of infections and casualties were reported all over India during this period. Delhi and Ma ... Full text Cite

COVID-19 may have increased global support for universal health coverage: multi-country observational study.

Journal Article Front Public Health · 2023 INTRODUCTION: The multiple risks generated by the COVID-19 pandemic intensified the debate about healthcare access and coverage. Whether the burden of disease caused by the coronavirus outbreak changed public opinion about healthcare provision remains uncl ... Full text Link to item Cite

Protocol for a multi-site randomized controlled trial of a stepped-care intervention for emergency department patients with panic-related anxiety.

Journal Article BMC Psychiatry · December 16, 2022 BACKGROUND: Approximately 40% of Emergency Department (ED) patients with chest pain meet diagnostic criteria for panic-related anxiety, but only 1-2% are correctly diagnosed and appropriately managed in the ED. A stepped-care model, which focuses on provid ... Full text Link to item Cite

AutoScore-Ordinal: an interpretable machine learning framework for generating scoring models for ordinal outcomes.

Journal Article BMC Med Res Methodol · November 4, 2022 BACKGROUND: Risk prediction models are useful tools in clinical decision-making which help with risk stratification and resource allocations and may lead to a better health care for patients. AutoScore is a machine learning-based automatic clinical score g ... Full text Link to item Cite

Benchmarking emergency department prediction models with machine learning and public electronic health records.

Journal Article Sci Data · October 27, 2022 The demand for emergency department (ED) services is increasing across the globe, particularly during the current COVID-19 pandemic. Clinical triage and risk assessment have become increasingly challenging due to the shortage of medical resources and the s ... Full text Link to item Cite

Estimating the optimal linear combination of predictors using spherically constrained optimization.

Journal Article BMC Bioinformatics · October 19, 2022 BACKGROUND: In the context of a binary classification problem, the optimal linear combination of continuous predictors can be estimated by maximizing the area under the receiver operating characteristic curve. For ordinal responses, the optimal predictor c ... Full text Link to item Cite

Evaluation of Combinations of Nudging, Pricing, and Labeling Strategies to Improve Diet Quality: A Virtual Grocery Store Experiment Employing a Multiphase Optimization Strategy.

Journal Article Ann Behav Med · August 30, 2022 BACKGROUND: Several intervention strategies have been shown to improve diet quality. However, there is limited evidence on the increase in effectiveness that may be achieved through select combinations of these strategies. PURPOSE: This study aimed to iden ... Full text Link to item Cite

A novel interpretable machine learning system to generate clinical risk scores: An application for predicting early mortality or unplanned readmission in a retrospective cohort study.

Journal Article PLOS Digit Health · June 2022 Risk scores are widely used for clinical decision making and commonly generated from logistic regression models. Machine-learning-based methods may work well for identifying important predictors to create parsimonious scores, but such 'black box' variable ... Full text Link to item Cite

Development and validation of an interpretable clinical score for early identification of acute kidney injury at the emergency department.

Journal Article Sci Rep · May 2, 2022 Acute kidney injury (AKI) in hospitalised patients is a common syndrome associated with poorer patient outcomes. Clinical risk scores can be used for the early identification of patients at risk of AKI. We conducted a retrospective study using electronic h ... Full text Link to item Cite

AutoScore-Imbalance: An interpretable machine learning tool for development of clinical scores with rare events data.

Journal Article J Biomed Inform · May 2022 BACKGROUND: Medical decision-making impacts both individual and public health. Clinical scores are commonly used among various decision-making models to determine the degree of disease deterioration at the bedside. AutoScore was proposed as a useful clinic ... Full text Link to item Cite

Shapley variable importance cloud for interpretable machine learning.

Journal Article Patterns (N Y) · April 8, 2022 Interpretable machine learning has been focusing on explaining final models that optimize performance. The state-of-the-art Shapley additive explanations (SHAP) locally explains the variable impact on individual predictions and has recently been extended t ... Full text Link to item Cite

A pilot sequential multiple assignment randomized trial (SMART) protocol for developing an adaptive coaching intervention around a mobile application for athletes to improve carbohydrate periodization behavior.

Journal Article Contemp Clin Trials Commun · April 2022 BACKGROUND: It has recently been identified that manipulating carbohydrate availability around exercise activity can enhance training-induced metabolic adaptations. Despite this approach being accepted in the athletic populations, athletes do not systemati ... Full text Link to item Cite

Leveraging Large-Scale Electronic Health Records and Interpretable Machine Learning for Clinical Decision Making at the Emergency Department: Protocol for System Development and Validation.

Journal Article JMIR Res Protoc · March 25, 2022 BACKGROUND: There is a growing demand globally for emergency department (ED) services. An increase in ED visits has resulted in overcrowding and longer waiting times. The triage process plays a crucial role in assessing and stratifying patients' risks and ... Full text Link to item Cite

Development and validation of an interpretable machine learning scoring tool for estimating time to emergency readmissions.

Journal Article EClinicalMedicine · March 2022 BACKGROUND: Emergency readmission poses an additional burden on both patients and healthcare systems. Risk stratification is the first step of transitional care interventions targeted at reducing readmission. To accurately predict the short- and intermedia ... Full text Link to item Cite

Daily Motivational Text Messages to Promote Physical Activity in University Students: Results From a Microrandomized Trial.

Journal Article Ann Behav Med · February 11, 2022 BACKGROUND: Low physical activity is an important risk factor for common physical and mental disorders. Physical activity interventions delivered via smartphones can help users maintain and increase physical activity, but outcomes have been mixed. PURPOSE: ... Full text Link to item Cite

Deep learning for temporal data representation in electronic health records: A systematic review of challenges and methodologies.

Journal Article J Biomed Inform · February 2022 OBJECTIVE: Temporal electronic health records (EHRs) contain a wealth of information for secondary uses, such as clinical events prediction and chronic disease management. However, challenges exist for temporal data representation. We therefore sought to i ... Full text Link to item Cite

Accounting for the role of asymptomatic patients in understanding the dynamics of the COVID-19 pandemic: A case study from Singapore

Journal Article Epidemiologic Methods · February 1, 2022 Objectives: To forecast the true growth of COVID-19 cases in Singapore after accounting for asymptomatic infections, we study and make modifications to the SEIR (Susceptible-Exposed-Infected-Recovered) epidemiological model by incorporating hospitalization ... Full text Cite

A musculoskeletal ultrasound program as an intervention to improve disease modifying anti-rheumatic drugs adherence in rheumatoid arthritis: a randomized controlled trial.

Journal Article Scand J Rheumatol · January 2022 Objectives: To evaluate the effect of a musculoskeletal ultrasound programme (MUSP) applying real-time ultrasonography with reinforcement of findings by a rheumatologist on improving disease-modifying anti-rheumatic drugs (DMARDs) adherence in rheumatoid a ... Full text Link to item Cite

Incentives for Uptake of and Adherence to Outpatient Stroke Rehabilitation Services: A 3-Arm Randomized Controlled Trial.

Journal Article Arch Phys Med Rehabil · January 2022 OBJECTIVE: To determine if rehabilitation uptake and adherence can be increased by providing coordinated transportation (increased convenience) and eliminating out-of-pocket costs (reduced expense). DESIGN: Three-arm randomized controlled trial. SETTING: S ... Full text Open Access Link to item Cite

AutoScore-Survival: Developing interpretable machine learning-based time-to-event scores with right-censored survival data.

Journal Article J Biomed Inform · January 2022 BACKGROUND: Scoring systems are highly interpretable and widely used to evaluate time-to-event outcomes in healthcare research. However, existing time-to-event scores are predominantly created ad-hoc using a few manually selected variables based on clinici ... Full text Link to item Cite

Dynamic Treatment Regimes for Optimizing Healthcare

Chapter · January 1, 2022 The study of evidence-based dynamic treatment regimes (DTRs) comprises an important line of methodological research within the domain of personalized medicine, a medical paradigm that transitions from the one-size-fits-all ideology. In this chapter we aim ... Full text Cite

A Text Messaging Intervention (StayWell at Home) to Counteract Depression and Anxiety During COVID-19 Social Distancing: Pre-Post Study.

Journal Article JMIR Ment Health · November 1, 2021 BACKGROUND: Social distancing and stay-at-home orders are critical interventions to slow down person-to-person transmission of COVID-19. While these societal changes help contain the pandemic, they also have unintended negative consequences, including anxi ... Full text Link to item Cite

Sequential Multiple Assignment Randomized Trial (SMART) to identify optimal sequences of telemedicine interventions for improving initiation of insulin therapy: A simulation study.

Journal Article BMC Med Res Methodol · September 30, 2021 BACKGROUND: To examine the value of a Sequential Multiple Assignment Randomized Trial (SMART) design compared to a conventional randomized control trial (RCT) for telemedicine strategies to support titration of insulin therapy for Type 2 Diabetes Mellitus ... Full text Open Access Link to item Cite

Development and Assessment of an Interpretable Machine Learning Triage Tool for Estimating Mortality After Emergency Admissions.

Journal Article JAMA Netw Open · August 2, 2021 IMPORTANCE: Triage in the emergency department (ED) is a complex clinical judgment based on the tacit understanding of the patient's likelihood of survival, availability of medical resources, and local practices. Although a scoring tool could be valuable i ... Full text Open Access Link to item Cite

A sequential significance test for treatment by covariate interactions

Journal Article Statistica Sinica · July 1, 2021 Biomedical and clinical research is gradually shifting from a traditional “one-size-fits-all” approach to a new paradigm of personalized medicine. An important step in this direction is to identify the treatment-covariate interactions. Our setting may incl ... Full text Cite

Adaptive learning algorithms to optimize mobile applications for behavioral health: guidelines for design decisions.

Journal Article J Am Med Inform Assoc · June 12, 2021 OBJECTIVE: Providing behavioral health interventions via smartphones allows these interventions to be adapted to the changing behavior, preferences, and needs of individuals. This can be achieved through reinforcement learning (RL), a sub-area of machine l ... Full text Link to item Cite

Abstract P227: Incentives for Uptake and Adherence With Outpatient Stroke Rehabilitation: A Three Arm Randomized Controlled Trial

Conference Stroke · March 2021 Introduction: While rehabilitation has been demonstrated to be effective in improving outcomes of stroke, uptake of outpatient rehabilitation services (ORS) in Singapore remains relatively low. This s ... Full text Cite

A scoping review of studies using observational data to optimise dynamic treatment regimens.

Journal Article BMC Med Res Methodol · February 22, 2021 BACKGROUND: Dynamic treatment regimens (DTRs) formalise the multi-stage and dynamic decision problems that clinicians often face when treating chronic or progressive medical conditions. Compared to randomised controlled trials, using observational data to ... Full text Link to item Cite

Sample size calculation based on precision for pilot sequential multiple assignment randomized trial (SMART).

Journal Article Biom J · February 2021 The sequential multiple assignment randomized trial (SMART) is a design used to develop dynamic treatment regimes (DTRs). Given that DTRs are generally less well researched, pilot SMART studies are often necessary. One challenge in pilot SMART is to determ ... Full text Link to item Cite

A Text Messaging Intervention for Coping With Social Distancing During COVID-19 (StayWell at Home): Protocol for a Randomized Controlled Trial.

Journal Article JMIR Res Protoc · January 14, 2021 BACKGROUND: Social distancing is a crucial intervention to slow down person-to-person transmission of COVID-19. However, social distancing has negative consequences, including increases in depression and anxiety. Digital interventions, such as text messagi ... Full text Link to item Cite

AutoScore: A Machine Learning-Based Automatic Clinical Score Generator and Its Application to Mortality Prediction Using Electronic Health Records.

Journal Article JMIR Med Inform · October 21, 2020 BACKGROUND: Risk scores can be useful in clinical risk stratification and accurate allocations of medical resources, helping health providers improve patient care. Point-based scores are more understandable and explainable than other complex models and are ... Full text Link to item Cite

mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE Study.

Journal Article BMJ Open · August 20, 2020 INTRODUCTION: Depression and diabetes are highly disabling diseases with a high prevalence and high rate of comorbidity, particularly in low-income ethnic minority patients. Though comorbidity increases the risk of adverse outcomes and mortality, most clin ... Full text Link to item Cite

COVID-19 in India: Statewise Analysis and Prediction.

Journal Article JMIR Public Health Surveill · August 12, 2020 BACKGROUND: The highly infectious coronavirus disease (COVID-19) was first detected in Wuhan, China in December 2019 and subsequently spread to 212 countries and territories around the world, infecting millions of people. In India, a large country of about ... Full text Link to item Cite

Heart rate n-variability (HRnV) and its application to risk stratification of chest pain patients in the emergency department.

Journal Article BMC Cardiovasc Disord · April 10, 2020 BACKGROUND: Chest pain is one of the most common complaints among patients presenting to the emergency department (ED). Causes of chest pain can be benign or life threatening, making accurate risk stratification a critical issue in the ED. In addition to t ... Full text Link to item Cite

Noninferiority and equivalence tests in sequential, multiple assignment, randomized trials (SMARTs).

Journal Article Psychol Methods · April 2020 Adaptive interventions (AIs) are increasingly popular in the behavioral sciences. An AI is a sequence of decision rules that specify for whom and under what conditions different intervention options should be offered, in order to address the changing needs ... Full text Link to item Cite

SMARTp: A SMART design for nonsurgical treatments of chronic periodontitis with spatially referenced and nonrandomly missing skewed outcomes.

Journal Article Biom J · March 2020 This paper proposes dynamic treatment regimes (DTRs) as effective individualized treatment strategies for managing chronic periodontitis. The proposed DTRs are studied via SMARTp-a two-stage sequential multiple assignment randomized trial (SMART) design. F ... Full text Link to item Cite

Novel model for predicting inpatient mortality after emergency admission to hospital in Singapore: retrospective observational study.

Journal Article BMJ Open · September 26, 2019 OBJECTIVES: To identify risk factors for inpatient mortality after patients' emergency admission and to create a novel model predicting inpatient mortality risk. DESIGN: This was a retrospective observational study using data extracted from electronic heal ... Full text Open Access Link to item Cite

Shared Care for Patients with Diabetes at Risk of Retinopathy: A Feasibility Trial.

Journal Article Int J Integr Care · September 18, 2019 PURPOSE: While diabetes is a chronic disease, in many health care systems patients with diabetes at risk of diabetic retinopathy (DR) are managed in hospital settings. Aim of this feasibility study is to assess the quality of care and economic benefits of ... Full text Link to item Cite

Pre-operative pressure pain thresholds do not meaningfully explain satisfaction or improvement in pain after knee replacement: a cohort study.

Journal Article Osteoarthritis Cartilage · January 2019 OBJECTIVES: Pain sensitization could be a risk factor for poor outcomes after knee replacement surgery (KR) for knee osteoarthritis (KOA). We aimed to evaluate the association between pre-operative central and peripheral pain sensitization measured using a ... Full text Link to item Cite

Modelling of low count heavy tailed time series data consisting large number of zeros and ones

Journal Article Statistical Methods and Applications · August 10, 2018 In this paper, we construct a new mixture of geometric INAR(1) process for modeling over-dispersed count time series data, in particular data consisting of large number of zeros and ones. For some real data sets, the existing INAR(1) processes do not fit w ... Full text Cite

The Effectiveness of Web-Based Tailored Smoking Cessation Interventions on the Quitting Process (Project Quit): Secondary Analysis of a Randomized Controlled Trial.

Journal Article J Med Internet Res · June 20, 2018 BACKGROUND: Project Quit was a randomized Web-based smoking cessation trial designed and conducted by researchers from the University of Michigan, where its primary outcome was the 7-day point prevalence. One drawback of such an outcome is that it only foc ... Full text Link to item Cite

Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial.

Journal Article Osteoarthritis Cartilage · May 2018 OBJECTIVES: Uric acid may activate an innate immune response in osteoarthritis (OA), contributing to disease pathology and progression. We evaluated the effectiveness of colchicine on pain and function in symptomatic knee OA (KOA) and the underlying mechan ... Full text Link to item Cite

Utility of a Medical Alert Protection System compared to telephone follow-up only for home-alone elderly presenting to the ED - A randomized controlled trial.

Journal Article Am J Emerg Med · April 2018 OBJECTIVE: Medical Alert Protection Systems (MAPS) are a form of assistive technology designed to support independent living in the care of elderly patients in the community. We aimed to investigate the utility of using such a device (eAlert! System) in el ... Full text Link to item Cite

Non-regular inference for dynamic weighted ordinary least squares: understanding the impact of solid food intake in infancy on childhood weight.

Journal Article Biostatistics · April 1, 2018 A dynamic treatment regime (DTR) is a set of decision rules to be applied across multiple stages of treatments. The decisions are tailored to individuals, by inputting an individual's observed characteristics and outputting a treatment decision at each sta ... Full text Link to item Cite

Shared Cared for Stable Glaucoma Patients: Economic Benefits and Patient-centered Outcomes of a Feasibility Trial.

Journal Article J Glaucoma · February 2018 PURPOSE: The purpose of this article is to assess the quality of care and economic benefits of a shared care model managing patients with stable glaucoma in a primary eye care (PEC) clinic compared with a tertiary specialist outpatient clinic (SOC) in Sing ... Full text Link to item Cite

Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005-2008.

Journal Article BMC Obes · 2018 BACKGROUND: Obesity is positively associated with low-level chronic inflammation, and negatively associated with several indices of health-related quality of life (HRQOL). It is however not clear if obesity-associated inflammation is partly responsible for ... Full text Link to item Cite

Does Medicaid Coverage Modify the Relationship between Glycemic Status and Teeth Present in Older Adults?

Journal Article J Health Care Poor Underserved · 2018 Understanding the relationships among diabetes, teeth present, and dental insurance is essential to improving primary and oral health care. Participants were older adults who attended senior centers in northern Manhattan (New York, N.Y.). Sociodemographic, ... Full text Link to item Cite

Estimating peer density effects on oral health for community-based older adults.

Journal Article BMC Oral Health · December 29, 2017 BACKGROUND: As part of a long-standing line of research regarding how peer density affects health, researchers have sought to understand the multifaceted ways that the density of contemporaries living and interacting in proximity to one another influence s ... Full text Link to item Cite

Interval increase in the prevalence of symptomatic cholelithiasis-associated non-alcoholic fatty liver disease over a ten-year period in an Asian population.

Journal Article Singapore Med J · December 2017 INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is frequently associated with cholelithiasis. The prevalence of NAFLD in Asia has been on the rise, but the magnitude of this increase had not been studied previously. METHODS: A retrospective cohort ... Full text Link to item Cite

Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey.

Journal Article J Gerontol A Biol Sci Med Sci · October 2016 BACKGROUND: Vitamin D has a neuroprotective function, potentially important for the prevention of cognitive decline. Prospective studies from Western countries support an association between lower vitamin D level and future cognitive decline in elderly peo ... Full text Open Access Link to item Cite

Third Places for Health Promotion with Older Adults: Using the Consolidated Framework for Implementation Research to Enhance Program Implementation and Evaluation.

Journal Article J Urban Health · October 2016 This study extends the concept of third places to include community sites where older adults gather, often for meals or companionship. The Consolidated Framework for Implementation Research guided program implementation and evaluation. Depending upon healt ... Full text Link to item Cite

Estimating optimal shared-parameter dynamic regimens with application to a multistage depression clinical trial.

Journal Article Biometrics · September 2016 A dynamic treatment regimen consists of decision rules that recommend how to individualize treatment to patients based on available treatment and covariate history. In many scientific domains, these decision rules are shared across stages of intervention. ... Full text Link to item Cite

Q-learning residual analysis: application to the effectiveness of sequences of antipsychotic medications for patients with schizophrenia.

Journal Article Stat Med · June 15, 2016 Q-learning is a regression-based approach that uses longitudinal data to construct dynamic treatment regimes, which are sequences of decision rules that use patient information to inform future treatment decisions. An optimal dynamic treatment regime is co ... Full text Link to item Cite

Sequential multiple assignment randomized trial (SMART) with adaptive randomization for quality improvement in depression treatment program.

Journal Article Biometrics · June 2015 Implementation study is an important tool for deploying state-of-the-art treatments from clinical efficacy studies into a treatment program, with the dual goals of learning about effectiveness of the treatments and improving the quality of care for patient ... Full text Link to item Cite

Colchicine effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): study protocol for a randomized controlled trial.

Journal Article Trials · April 30, 2015 BACKGROUND: Despite the high prevalence and global impact of knee osteoarthritis (KOA), current treatments are palliative. No disease modifying anti-osteoarthritic drug (DMOAD) has been approved. We recently demonstrated significant involvement of uric aci ... Full text Open Access Link to item Cite

Pneumocystis jirovecii pneumonia in patients with autoimmune disease on high-dose glucocorticoid.

Journal Article J Clin Rheumatol · March 2015 OBJECTIVE: Indications for Pneumocystis jirovecii pneumonia (PCP) prophylaxis in patients with autoimmune disease remain unclear. We aimed to determine (1) the incidence of PCP in patients with autoimmune disease in general, in a clinical setting where pro ... Full text Link to item Cite

Inference about the expected performance of a data-driven dynamic treatment regime.

Journal Article Clin Trials · August 2014 BACKGROUND: A dynamic treatment regime (DTR) comprises a sequence of decision rules, one per stage of intervention, that recommends how to individualize treatment to patients based on evolving treatment and covariate history. These regimes are useful for m ... Full text Link to item Cite

Patterns of chronic conditions in older adults: exploratory spatial findings from the ElderSmile program.

Journal Article Am J Prev Med · June 2014 BACKGROUND: The increasing prevalence of primary care-sensitive conditions, notably diabetes and hypertension, among older adults presents a challenge to the public health community. Systems science conceptualizations of health, along with considerations o ... Full text Link to item Cite

Dynamic Treatment Regimes.

Journal Article Annu Rev Stat Appl · 2014 A dynamic treatment regime consists of a sequence of decision rules, one per stage of intervention, that dictate how to individualize treatments to patients based on evolving treatment and covariate history. These regimes are particularly useful for managi ... Full text Link to item Cite

Screening experiments and the use of fractional factorial designs in behavioral intervention research.

Journal Article Am J Public Health · August 2008 Health behavior intervention studies have focused primarily on comparing new programs and existing programs via randomized controlled trials. However, numbers of possible components (factors) are increasing dramatically as a result of developments in scien ... Full text Link to item Cite