Journal articleJMIR Res Protoc · August 4, 2026
BACKGROUND: The current landscape of emergency care (EC) is marked by high demand, leading to issues such as emergency department boarding, overcrowding, and subsequent delays that impact the quality and safety of patient care. Integrating data science int ...
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Journal articleContemp Clin Trials · August 2026
BACKGROUND: Obesity is a growing epidemic associated with cardiovascular disease (CVD). The RESILIENCE study aimed to understand the factors underlying heterogeneity in CVD development among individuals with obesity as well as the variability in response t ...
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Journal articleJAMIA Open · August 2026
OBJECTIVES: Building on innovations for autism detection-where artificial intelligence (AI)-based models monitor clinical data within electronic health records-this study evaluates the context for clinical decision support (CDS) deployment and identifies d ...
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Journal articleClin Infect Dis · July 8, 2026
BACKGROUND: External comparisons of hospital antimicrobial use (AU), risk-adjusted using encounter characteristics, may better inform antimicrobial stewardship program strategy. Barriers to encounter-level modeling include feasibility of data collection an ...
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Journal articleJAMA Netw Open · July 1, 2026
IMPORTANCE: Patient portal messaging volume has increased substantially and is linked to clinician burnout. In response, health systems are increasingly adopting large language models (LLMs) to generate draft replies to patient messages, yet little is know ...
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Journal articlemedRxiv · June 24, 2026
BACKGROUND: Despite evidence that early intervention can prevent or delay progression to type 2 diabetes, more than 80% of individuals with prediabetes in the United States remain undiagnosed, underscoring the need for scalable strategies to increase uptak ...
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Journal articleContemp Clin Trials Commun · June 2026
Asthma is a common pediatric disease of the airways. Obesity among children increases the risk of asthma and is associated with a unique non-allergic asthma phenotype that is highly symptomatic and often unresponsive to conventional drugs. However, the mec ...
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Journal articleJAMIA Open · June 2026
OBJECTIVE: Speech-language delay (SLD) is a developmental condition often identified by pediatricians. While early intervention is recommended, it is common for pediatricians to take a "watch and wait" approach. We sought to assess whether there is discord ...
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Journal articleBMJ Open Qual · May 6, 2026
BACKGROUND: This scoping review documents participatory system dynamics (PSD) applications in implementation science (IS) studies following a recent, increased integration of the two fields in the USA. It aims to illustrate 'how' and 'why' PSD modelling im ...
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Journal articleJ Dev Behav Pediatr · May 2026
OBJECTIVE: The Survey of Well-being of Young Children (SWYC) supports developmental screening at well-child visits. However, a US Preventive Services Task Force report suggests insufficient evidence for this approach for speech-language delay identificatio ...
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Journal articleJ Am Med Inform Assoc · May 1, 2026
OBJECTIVE: This study aims to compare the effectiveness of 2 ambient AI scribe technologies in reducing physician burnout, improving workflow satisfaction, and enhancing documentation efficiency through a randomized crossover trial. MATERIALS AND METHODS: ...
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Journal articleNature Mental Health · May 1, 2026
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition that can negatively impact long-term outcomes for individuals. Early diagnosis is critical, yet demographic and clinical disparities can delay detection. Using electro ...
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Journal articleJAMA Netw Open · May 1, 2026
IMPORTANCE: Optimizing participant recruitment is critical to the success and generalizability of clinical research, yet there is limited randomized clinical trial evidence comparing the effects of digital recruitment strategies and message framing on part ...
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Journal articleBMJ Open Diabetes Res Care · April 22, 2026
INTRODUCTION: Therapeutic inertia (failure to initiate or intensify therapy when therapeutic goals are unmet) contributes to poor glycemic control and diabetes-related complications. We assessed the extent of therapeutic inertia, defined as a lack of new p ...
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Journal articleJMIR Res Protoc · April 21, 2026
BACKGROUND: Clinical decision support (CDS) tools that provide patient-specific and evidence-based information to clinicians and care managers regarding patient risk for adverse outcomes have been a part of health care for decades. However, modern CDS, whi ...
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Journal articleJAMA Intern Med · April 1, 2026
IMPORTANCE: Patients with diabetes and food insecurity are at greater risk of adverse health outcomes. Effective strategies to promote healthy food access are urgently needed. OBJECTIVE: To evaluate the effect of a produce prescription (PRx) program on car ...
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Journal articleJAMA Netw Open · April 1, 2026
IMPORTANCE: The use of audiovisual aids in the consent process may improve comprehension and willingness to participate in research. However, data supporting this hypothesis are lacking. OBJECTIVE: To determine the impact of audiovisual augmentation of the ...
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Journal articleJ Perinatol · February 16, 2026
OBJECTIVE: Develop and validate predictive models for pulmonary hypertension (PH) in high-risk infants. STUDY DESIGN: We trained logistic regression (LR) and long short-term memory (LSTM) models using a multicenter cohort study of infants 22-28 weeks gesta ...
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Journal articleJ Clin Child Adolesc Psychol · 2026
OBJECTIVE: Co-occurring attention-deficit/hyperactivity disorder (ADHD) is present for many autistic children and is associated with increased impairments, unique treatment needs, and decreased response to autism-specific interventions. Diagnosing ADHD in ...
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Journal articleIEEE J Biomed Health Inform · January 2026
Clinical predictive models (CPMs) are crucial for forecasting patient outcomes using available electronic health record (EHR) data. Traditional time-to-event (TTE) models, like the Cox proportional hazards model, assume that hazard ratios remain constant o ...
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Journal articleJ Clin Neurosci · January 2026
BACKGROUND: Health disparities in traumatic brain injury (TBI) risk and outcomes have been observed. Neighborhood-level social determinants of health (SDOH), such as built environment and socioeconomic disadvantage, may contribute to these disparities. To ...
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Journal articleAm J Epidemiol · December 2, 2025
One of the key limitations of electronic health record (EHR) data is that not all health care encounters are observed. The degree to which patient information is captured is referred to as observability. Poor observability, particularly differential observ ...
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Journal articleJAMIA Open · December 2025
OBJECTIVES: To address algorithmic bias in clinical prediction models related to the timing of diagnosis, we evaluated the efficacy of mixture cure models that integrate time-to-event and binary classification frameworks to predict diagnoses. MATERIALS AND ...
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Journal articleJMIR Med Inform · November 27, 2025
BACKGROUND: Developing computable phenotypes (CP) based on electronic health records (EHR) data requires "gold-standard" labels for the outcome of interest. To generate these labels, clinicians typically chart-review a subset of patient charts. Charts to b ...
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Journal articleJ Intensive Care Soc · November 2025
BACKGROUND: Beta-blockers have been studied for potential benefits in traumatic brain injury (TBI). This study aimed to investigate the association between early beta-blocker exposure and brain injury biomarkers following moderate-severe TBI. METHODS: We c ...
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Journal articleNejm Catalyst Innovations in Care Delivery · October 1, 2025
As telehealth achieves a steady state in the post-Covid-19 pandemic health care landscape, health systems require operational models that can support clinicians across service lines. The authors describe a highly successful case study of a centralized tele ...
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Journal articleProc AAAI ACM Conf AI Ethics Soc · October 2025
Fairness metrics utilizing the area under the receiver operator characteristic curve (AUC) have gained increasing attention in high-stakes domains such as healthcare, finance, and criminal justice. In these domains, fairness is often evaluated over risk sc ...
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Journal articleVaccine · September 17, 2025
Real world data is an increasingly utilized resource for post-market monitoring of vaccines and provides insight into real world effectiveness. However, heterogeneous mechanisms may drive observed breakthrough infections among vaccinated individuals, such ...
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Journal articleJMIR Med Inform · March 4, 2025
BACKGROUND: Pharmacoepidemiology studies using electronic health record (EHR) data typically rely on medication prescriptions to determine which patients have received a medication. However, such data do not affirmatively indicate whether these prescriptio ...
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Journal articleJAMA Netw Open · March 3, 2025
IMPORTANCE: The rise of patient messages sent to clinicians via a patient portal has directly led to physician burnout and dissatisfaction, prompting uptake of artificial intelligence (AI) to alleviate this burden. It is important to understand patient pre ...
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Journal articleKidney360 · March 1, 2025
KEY POINTS: We found poor ability to distinguish among different causes of death using clinical information in the 30 days before death for patients on hemodialysis. We found that models of different causes of death identified similar associated clinical f ...
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Journal articleJ Am Med Inform Assoc · January 1, 2025
OBJECTIVES: This study aims to improve the ethical use of machine learning (ML)-based clinical prediction models (CPMs) in shared decision-making for patients with kidney failure on dialysis. We explore factors that inform acceptability, interpretability, ...
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Journal articleGastro Hep Adv · 2025
BACKGROUND AND AIMS: Despite causing significant morbidity and mortality, nonalcoholic fatty liver disease (NAFLD) is underdiagnosed. Clinical indices developed to identify hepatic steatosis are often used by providers but their potential for use at the po ...
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Journal articleNurs Outlook · 2025
Healthcare systems are increasingly integrating artificial intelligence and machine learning (AI/ML) tools into patient care, potentially influencing clinical decisions for millions. However, concerns are growing about these tools reinforcing systemic ineq ...
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Journal articleAm J Kidney Dis · December 2024
There has been a steady rise in the use of clinical decision support (CDS) tools to guide nephrology as well as general clinical care. Through guidance set by federal agencies and concerns raised by clinical investigators, there has been an equal rise in u ...
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Journal articleClin J Am Soc Nephrol · December 1, 2024
KEY POINTS: For patients with ESKD treated with hemodialysis, the causes of death reported by the United States Renal Data System and the National Death Index show substantial disagreement. In particular, the proportion of sudden cardiac death was almost t ...
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Journal articleClin J Am Soc Nephrol · December 1, 2024
KEY POINTS: Breast and prostate cancer screening were more frequent among patients on hemodialysis waitlisted for kidney transplant. Among patients not waitlisted for transplant, we found that screening rates were generally higher among patients with highe ...
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Journal articleHealth Serv Outcomes Res Methodol · October 23, 2024
Combining data from diverse sources including randomized controlled trials (RCTs) and observational datasets holds the potential to increase sample size, improve external validity, and gain a well-rounded view of the question under study. However, the prac ...
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Journal articleJ Autism Dev Disord · October 7, 2024
PURPOSE: We sought to understand whether a child's sex, age, race, ethnicity, caregiver education, family income, and/or number of endorsed autism signs are associated with a caregiver's decision to pursue an autism diagnostic evaluation after their child ...
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Journal articleContemp Clin Trials · October 2024
BACKGROUND: Patients with diabetes at risk of food insecurity face cost barriers to healthy eating and, as a result, poor health outcomes. Population health management strategies are needed to improve food security in real-world health system settings. We ...
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Journal articleJ Biomed Inform · September 2024
OBJECTIVE: This study aimed to develop a novel approach using routinely collected electronic health records (EHRs) data to improve the prediction of a rare event. We illustrated this using an example of improving early prediction of an autism diagnosis, gi ...
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Journal articleBMC Med Inform Decis Mak · July 24, 2024
BACKGROUND: Electronic Health Records (EHR) are widely used to develop clinical prediction models (CPMs). However, one of the challenges is that there is often a degree of informative missing data. For example, laboratory measures are typically taken when ...
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Journal articleAm J Kidney Dis · July 2024
RATIONALE & OBJECTIVE: The life expectancy of patients treated with maintenance hemodialysis (MHD) is heterogeneous. Knowledge of life-expectancy may focus care decisions on near-term versus long-term goals. The current tools are limited and focus on near- ...
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Journal articleProc Mach Learn Res · July 2024
The use of machine learning models to predict clinical outcomes from (longitudinal) electronic health record (EHR) data is becoming increasingly popular due to advances in deep architectures, representation learning, and the growing availability of large E ...
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Journal articleCrit Care Med · April 1, 2024
OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ...
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Journal articleLupus · April 2024
OBJECTIVES: We sought to identify the impact of preeclampsia on infant and maternal health among women with rheumatic diseases. METHODS: A retrospective single-center cohort study was conducted to describe pregnancy and infant outcomes among women with sys ...
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Journal articleJ Am Med Inform Assoc · February 16, 2024
OBJECTIVE: The complexity and rapid pace of development of algorithmic technologies pose challenges for their regulation and oversight in healthcare settings. We sought to improve our institution's approach to evaluation and governance of algorithmic techn ...
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Journal articleJ Clin Transl Sci · 2024
OBJECTIVE: Type 2 diabetes (T2DM) poses a significant public health challenge, with pronounced disparities in control and outcomes. Social determinants of health (SDoH) significantly contribute to these disparities, affecting healthcare access, neighborhoo ...
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Journal articleFront Neurol · 2024
BACKGROUND: Traumatic brain injury (TBI) disrupts normal brain tissue and functions, leading to high mortality and disability. Severe TBI (sTBI) causes prolonged cognitive, functional, and multi-organ dysfunction. Dysfunction of the autonomic nervous syste ...
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Journal articleCrit Care Explor · September 2023
OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ...
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Journal articleJMIR Med Inform · August 22, 2023
BACKGROUND: Throughout the COVID-19 pandemic, many hospitals conducted routine testing of hospitalized patients for SARS-CoV-2 infection upon admission. Some of these patients are admitted for reasons unrelated to COVID-19 and incidentally test positive fo ...
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Journal articleJMIR Med Inform · June 17, 2023
BACKGROUND: Throughout the COVID-19 pandemic, many hospitals conducted routine testing of hospitalized patients for SARS-CoV-2 infection upon admission. Some of these patients are admitted for reasons unrelated to COVID-19, and incidentally test positive f ...
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Journal articleSTAR Protoc · June 16, 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 ...
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Journal articleLaryngoscope Investig Otolaryngol · June 2023
OBJECTIVES: Tonsillectomy is a common pediatric surgery, and pain is an important consideration in recovery. Due to the opioid epidemic, individual states, medical societies, and institutions have all taken steps to limit postoperative opioids, yet few stu ...
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Journal articleJ Intensive Care Med · May 2023
Objectives: Describe contemporary ECMO utilization patterns among patients with traumatic brain injury (TBI) and examine clinical outcomes among TBI patients requiring ECMO. Design: Retrospective cohort study. Setting: Premier Healthcare Database (PHD) bet ...
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Journal articleHosp Pediatr · May 1, 2023
BACKGROUND: Identifying children at high risk with complex health needs (CCHN) who have intersecting medical and social needs is challenging. This study's objectives were to (1) develop and evaluate an electronic health record (EHR)-based clinical predicti ...
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Journal articleDrug Saf · March 2023
INTRODUCTION: Detection of adverse reactions to drugs and biologic agents is an important component of regulatory approval and post-market safety evaluation. Real-world data, including insurance claims and electronic health records data, are increasingly u ...
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Journal articleStatistics in Biopharmaceutical Research · January 1, 2023
Real-world data (RWD), such as electronic health records, reimbursement requests as adjudicated by health insurance companies, and health survey data as collected by government agencies or other research organizations, are increasingly used in drug develop ...
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Journal articleStatistics in Biopharmaceutical Research · January 1, 2023
Real-world evidence (RWE), derived from data from “real-world” clinical practice and medical product utilization, is an increasingly important source of evidence that holds great potential to increase efficiency and improve clinical development and life cy ...
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Journal articleAnesth Analg · December 1, 2022
BACKGROUND: Early hypotension after severe traumatic brain injury (sTBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors, commonly norepinephrine and phenylephrine, to suppo ...
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Journal articleJ Urban Health · December 2022
There is tremendous interest in understanding how neighborhoods impact health by linking extant social and environmental drivers of health (SDOH) data with electronic health record (EHR) data. Studies quantifying such associations often use static neighbor ...
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Journal articleBMJ Open Diabetes Res Care · November 2022
INTRODUCTION: Adolescents and young adults (AYAs) with type 1 diabetes (T1D) are at risk of suboptimal glycemic control and high acute care utilization. Little is known about the optimal age to transfer people with T1D to adult care, or time gap between co ...
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Journal articleNeurosurgery · September 1, 2022
BACKGROUND: Extracranial multisystem organ failure is a common sequela of severe traumatic brain injury (TBI). Risk factors for developing circulatory shock and long-term functional outcomes of this patient subset are poorly understood. OBJECTIVE: To ident ...
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Journal articleJ Am Med Inform Assoc · August 16, 2022
Artificial intelligence/machine learning models are being rapidly developed and used in clinical practice. However, many models are deployed without a clear understanding of clinical or operational impact and frequently lack monitoring plans that can detec ...
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Journal articlePediatrics · June 1, 2022
OBJECTIVES: Over 6 million pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have occurred in the United States, but risk factors for infection remain poorly defined. We sought to evaluate the association between asthma and ...
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Journal articleJ 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 ...
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Journal articleWorld Neurosurg · May 2022
BACKGROUND: Missing data is a typical problem in clinical studies, where the value of variables of interest is not measured or collected for some patients. This article aimed to review imputation approaches for missing values and their application in neuro ...
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Journal articleBMC Med Inform Decis Mak · April 24, 2022
BACKGROUND: In the early stages of the COVID-19 pandemic our institution was interested in forecasting how long surgical patients receiving elective procedures would spend in the hospital. Initial examination of our models indicated that, due to the skewed ...
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Journal articleBMC Med Inform Decis Mak · April 22, 2022
BACKGROUND: Asthma exacerbations are triggered by a variety of clinical and environmental factors, but their relative impacts on exacerbation risk are unclear. There is a critical need to develop methods to identify children at high-risk for future exacerb ...
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Journal articleJ Am Med Inform Assoc · April 13, 2022
OBJECTIVE: Electronic health records have incomplete capture of patient outcomes. We consider the case when observability is differential across a predictor. Including such a predictor (sensitive variable) can lead to algorithmic bias, potentially exacerba ...
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Journal articlePatterns (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 ...
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Journal articleBMC Med Inform Decis Mak · March 29, 2022
BACKGROUND: Clinical decision support (CDS) tools built using adult data do not typically perform well for children. We explored how best to leverage adult data to improve the performance of such tools. This study assesses whether it is better to build CDS ...
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Journal articleSoc Sci Med · March 2022
Although local policies aimed at reducing childhood health inequities can benefit from local data, sample size constraints in population representative health surveys often prevent rigorous evaluations of child health disparities and health care patterns a ...
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Journal articleBMJ Open Qual · March 2022
INTRODUCTION: Reducing unplanned hospital readmissions is an important priority for all hospitals and health systems. Hospital discharge can be complicated by discrepancies in the medication reconciliation and/or prescribing processes. Clinical pharmacist ...
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Journal articleNeurocrit Care · February 2022
BACKGROUND: Early hypotension following moderate to severe traumatic brain injury (TBI) is associated with increased mortality and poor long-term outcomes. Current guidelines suggest the use of intravenous vasopressors to support blood pressure following T ...
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Journal articleJ 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 ...
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Journal articleJ Pediatr Health Care · 2022
OBJECTIVES: To evaluate feasibility and acceptability of post-hospitalization telemedicine video visits (TMVV) during hospital-to-home transitions for children with medical complexity (CMC); and explore associations with hospital utilization, caregiver sel ...
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Journal articleJ Am Pharm Assoc (2003) · 2022
BACKGROUND: Sodium-glucose transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists have demonstrated beneficial outcomes in patients with type 2 diabetes at high cardiovascular risk. Unfortunately, these agents are still underutilized ...
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Journal articleACI Open · January 2022
Abstract
Objective Several risk scores have been developed and tested on coronavirus disease 2019 (COVID-19) patients to predict clinical decompensation. We aimed to compare an institutional, automated, custom-bui ...
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Journal articlePrev Med Rep · December 2021
Data on patterns of weight change among adults with overweight or obesity are minimal. We aimed to examine patterns of weight change and associated hospitalizations in a large health system, and to develop a model to predict 2-year significant weight gain. ...
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Journal articleCrit Care Med · October 1, 2021
OBJECTIVES: Traumatic brain injury is a leading cause of death and disability in the United States. While the impact of early multiple organ dysfunction syndrome has been studied in many critical care paradigms, the clinical impact of early multiple organ ...
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Journal articlePediatr Pulmonol · October 2021
The COVID-19 pandemic has had a profound impact on healthcare access and utilization, which could have important implications for children with chronic diseases, including asthma. We sought to evaluate changes in healthcare utilization and outcomes in chil ...
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Journal articleJAMA 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 ...
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Journal articleProc AAAI Conf Artif Intell · May 18, 2021
Combining the increasing availability and abundance of healthcare data and the current advances in machine learning methods have created renewed opportunities to improve clinical decision support systems. However, in healthcare risk prediction applications ...
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Journal articleJAMA Netw Open · April 1, 2021
IMPORTANCE: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. OBJECTIVE: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical ...
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Journal articleJAMA Netw Open · March 1, 2021
IMPORTANCE: Comparisons of antimicrobial use among hospitals are difficult to interpret owing to variations in patient case mix. Risk-adjustment strategies incorporating larger numbers of variables haves been proposed as a method to improve comparisons for ...
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Journal articleAm Heart J · January 2021
UNLABELLED: Statins failed to reduce cardiovascular (CV) events in trials of patients on dialysis. However, trial populations used criteria that often excluded those with atherosclerotic heart disease (ASHD), in whom statins have the greatest benefit, and ...
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Journal articlePediatrics · December 2020
BACKGROUND: Asthma remains a leading cause of hospitalization in US children. Well-child care (WCC) visits are routinely recommended, but how WCC adherence relates to asthma outcomes is poorly described. METHODS: We conducted a retrospective longitudinal c ...
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Journal articleJAMA Netw Open · November 2, 2020
IMPORTANCE: Hospitals ceased most elective procedures during the height of coronavirus disease 2019 (COVID-19) infections. As hospitals begin to recommence elective procedures, it is necessary to have a means to assess how resource intensive a given case m ...
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Journal articleCleft Palate Craniofac J · November 2020
OBJECTIVE: To characterize operative care for cleft lip and/or palate (CL/P) based on location (ie, from American Cleft Palate Craniofacial Association [ACPA]-approved multidisciplinary teams or from community providers). DESIGN: Cross-sectional analysis o ...
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Journal articleBMC Public Health · October 29, 2020
BACKGROUND: Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primaril ...
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Journal articleJMIR 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 ...
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Journal articleRespir Care · September 2020
BACKGROUND: Unanticipated respiratory compromise that lead to unplanned intubations is a known phenomenon in hospitalized patients. Most events occur in patients at high risk in well-monitored units; less is known about the incidence, risk factors, and tra ...
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Journal articleUrol Pract · September 2020
INTRODUCTION: We analyzed trends and explored implications of no-show rates in adult urology from provider related characteristics at an academic program. METHODS: No-show rates were determined from electronic health records of appointments in adult urolog ...
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Journal articleJ Pers Med · August 27, 2020
There is increasing application of machine learning tools to problems in healthcare, with an ultimate goal to improve patient safety and health outcomes. When applied appropriately, machine learning tools can augment clinical care provided to patients. How ...
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Journal articleJ Pers Med · August 26, 2020
Unplanned hospital readmissions represent a significant health care value problem with high costs and poor quality of care. A significant percentage of readmissions could be prevented if clinical inpatient teams were better able to predict which patients w ...
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Journal articleClin Trials · August 2020
Electronic health records data are becoming a key data resource in clinical research. Owing to issues of data efficiency, electronic health records data are being used for clinical trials. This includes both large-scale pragmatic trails and smaller-more fo ...
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Journal articleJ Clin Transl Sci · June 23, 2020
INTRODUCTION: Electronic health record (EHR) data have emerged as an important resource for population health and clinical research. There have been significant efforts to leverage EHR data for research; however, given data security concerns and the comple ...
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Journal articleJ Am Med Inform Assoc · May 1, 2020
OBJECTIVE: While electronic health record (EHR) systems store copious amounts of patient data, aggregating those data across patients can be challenging. Visual analytic tools that integrate with EHR systems allow clinicians to gain better insight and unde ...
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Journal articleNPJ Digit Med · February 10, 2020
As wearable technologies are being increasingly used for clinical research and healthcare, it is critical to understand their accuracy and determine how measurement errors may affect research conclusions and impact healthcare decision-making. Accuracy of w ...
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Journal articleJ Palliat Med · January 2020
Background: Hospital referral regions (HRRs) are often used to characterize inpatient referral patterns, but it is unknown how well these geographic regions are aligned with variation in Medicare-financed hospice care, which is largely provided at home. Ob ...
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Journal articleJ Appl Stat · 2020
Appointment no-shows have a negative impact on patient health and have caused substantial loss in resources and revenue for health care systems. Intervention strategies to reduce no-show rates can be more effective if targeted to the subpopulations of pati ...
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Journal articleMDM Policy Pract · 2020
Background. Identification of patients at risk of deteriorating during their hospitalization is an important concern. However, many off-shelf scores have poor in-center performance. In this article, we report our experience developing, implementing, and ev ...
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Journal articleNPJ Digit Med · 2020
As wearable technologies are being increasingly used for clinical research and healthcare, it is critical to understand their accuracy and determine how measurement errors may affect research conclusions and impact healthcare decision-making. Accuracy of w ...
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Journal articleJ Am Med Inform Assoc · December 1, 2019
OBJECTIVE: Electronic health records (EHR) data have become a central data source for clinical research. One concern for using EHR data is that the process through which individuals engage with the health system, and find themselves within EHR data, can be ...
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Journal articleCancer · September 1, 2019
BACKGROUND: The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) uses a 10-point scale (in which 0 indicates no distress and 10 indicates extreme distress) to measure patient-reported distress. In the current study, the authors sought ...
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Journal articleAIDS Patient Care STDS · August 2019
Uptake of pre-exposure prophylaxis (PrEP) has been limited among black and Latino men who have sex with men (MSM), especially in the southern United States. Public health departments and federally qualified health centers (FQHCs) serving predominantly unin ...
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Journal articleEndocr Pract · May 2019
Objective: This study evaluated whether there is a difference in the proportion of patients with type 2 diabetes who achieve a hemoglobin A1c (HbA1c) <7% within one year following treatment by an endocrinologist or primary care physician (PCP). Methods: We ...
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Journal articleJ Am Med Inform Assoc · May 1, 2019
OBJECTIVE: Participants enrolled into randomized controlled trials (RCTs) often do not reflect real-world populations. Previous research in how best to transport RCT results to target populations has focused on weighting RCT data to look like the target da ...
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Journal articleClin Pediatr (Phila) · April 2019
The impact of the Patient Protection and Affordable Care Act (PPACA) on children's access to surgical care is not well-defined. Our objective was to describe the early impact of PPACA on children's surgical care before and after Medicaid expansion in 2014. ...
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Journal articleCrit Care Med · January 2019
OBJECTIVES: Previous studies have looked at National Early Warning Score performance in predicting in-hospital deterioration and death, but data are lacking with respect to patient outcomes following implementation of National Early Warning Score. We sough ...
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Journal articleJ Surg Educ · November 2018
OBJECTIVE: The utilization of electronic health records (EHR) has become essential in the daily activities of physicians for documentation and as an information source. However, the amount of time spent by residents utilizing the EHR has not been thoroughl ...
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Journal articleJAMA Netw Open · September 7, 2018
IMPORTANCE: Data from electronic health records (EHRs) are increasingly used for risk prediction. However, EHRs do not reliably collect sociodemographic and neighborhood information, which has been shown to be associated with health. The added contribution ...
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Journal articleNephrol Dial Transplant · September 1, 2018
BACKGROUND: Little is known about the cardiovascular risks of incident atrial fibrillation/flutter (AF) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). METHODS: We studied older US patients who newly initiated HD for ESRD (200 ...
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Journal articleJ Am Med Inform Assoc · August 1, 2018
OBJECTIVE: As available data increases, so does the opportunity to develop risk scores on more refined patient populations. In this paper we assessed the ability to derive a risk score for a patient no-showing to a clinic visit. METHODS: Using data from 2 ...
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Journal articleProc Mach Learn Res · July 2018
Modern health data science applications leverage abundant molecular and electronic health data, providing opportunities for machine learning to build statistical models to support clinical practice. Time-to-event analysis, also called survival analysis, st ...
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Journal article35th International Conference on Machine Learning Icml 2018 · January 1, 2018
Modern health data science applications leverage abundant molecular and electronic health data; providing opportunities for machine learning to build statistical models to support clinical practice. Time-to-event analysis, also called survival analysis, st ...
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Journal articleEGEMS (Wash DC) · December 6, 2017
Electronic health record (EHR) data are becoming a primary resource for clinical research. Compared to traditional research data, such as those from clinical trials and epidemiologic cohorts, EHR data have a number of appealing characteristics. However, be ...
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Journal articleKidney Int Rep · November 2017
INTRODUCTION: Chronic kidney disease (CKD) patients have increased risks of sudden cardiac arrest and sudden cardiac death (SCA/SCD) that are not explained by traditional risk factors. We examined associations between serum potassium and SCA/SCD in a large ...
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Journal articlePediatrics · September 2017
BACKGROUND: Differences in NICU quality of care provided to very low birth weight (<1500 g) infants may contribute to the persistence of racial and/or ethnic disparity. An examination of such disparities in a population-based sample across multiple dimensi ...
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Journal articleStat Med · July 30, 2017
An increasingly important data source for the development of clinical risk prediction models is electronic health records (EHRs). One of their key advantages is that they contain data on many individuals collected over time. This allows one to incorporate ...
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Journal articleEur Heart J · June 14, 2017
Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operat ...
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Journal articleAm J Kidney Dis · June 2017
BACKGROUND: Controversy exists about any differences in longer-term safety across different intravenous iron formulations routinely used in hemodialysis (HD) patients. We exploited a natural experiment to compare outcomes of patients initiating HD therapy ...
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Journal articleJ Am Med Inform Assoc · April 1, 2017
OBJECTIVE: We assessed the sensitivity and specificity of 8 electronic health record (EHR)-based phenotypes for diabetes mellitus against gold-standard American Diabetes Association (ADA) diagnostic criteria via chart review by clinical experts. MATERIALS ...
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Journal articleJ Am Med Inform Assoc · January 2017
OBJECTIVE: Electronic health records (EHRs) are an increasingly common data source for clinical risk prediction, presenting both unique analytic opportunities and challenges. We sought to evaluate the current state of EHR based risk prediction modeling thr ...
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Journal articleJ Am Med Inform Assoc · January 2017
OBJECTIVE: Electronic health records (EHRs) are a resource for "big data" analytics, containing a variety of data elements. We investigate how different categories of information contribute to prediction of mortality over different time horizons among pati ...
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Journal articleFront Cardiovasc Med · 2017
PURPOSE: We tested whether providing a genetic risk score (GRS) for coronary artery disease (CAD) would serve as a motivator to improve adherence to risk-reducing strategies. METHODS: We randomized 94 participants with at least moderate risk of CAD to rece ...
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Journal articlePLoS One · 2017
Glatiramer acetate is used therapeutically in multiple sclerosis but also known for adverse effects including elevated coronary artery disease (CAD) risk. The mechanisms underlying the cardiovascular side effects of the medication are unclear. Here, we mad ...
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Journal articleJ Adolesc Health · December 2016
PURPOSE: The purpose of this study was to characterize young adult patients aged 19-25 years who are emergency department (ED) frequent users and study factors associated with frequent ED use. METHODS: ED visits among 19- to 25-year olds were identified fr ...
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Journal articleAm J Epidemiol · December 1, 2016
Electronic health records (EHRs) are an increasingly utilized resource for clinical research. While their size allows for many analytical opportunities, as with most observational data there is also the potential for bias. One of the key sources of bias in ...
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Journal articleEpidemiology · July 2016
BACKGROUND: Over the past two decades, there have been increasingly long waiting times for heart transplantation. We studied the relationship between heart transplant waiting time and transplant failure (removal from the waitlist, pretransplant death, or d ...
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Journal articleAnn Emerg Med · June 2016
STUDY OBJECTIVE: The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promo ...
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Journal articleInt J Biostat · May 1, 2016
Comparing the relative fit of competing models can be used to address many different scientific questions. In classical statistics one can, if appropriate, use likelihood ratio tests and information based criterion, whereas clinical medicine has tended to ...
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Journal articlePediatrics · March 2016
BACKGROUND: Regionalized care delivery purportedly optimizes care to vulnerable very low birth weight (VLBW; <1500 g) infants. However, a comprehensive assessment of quality of care delivery across different levels of NICUs has not been done. METHODS: We c ...
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Journal articleEBioMedicine · February 2016
BACKGROUND: Genome-wide association studies have identified polymorphisms linked to both smoking exposure and risk of lung cancer. The degree to which lung cancer risk is driven by increased smoking, genetics, or gene-environment interactions is not well u ...
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Journal articleBMJ Open Diabetes Res Care · 2016
OBJECTIVE: Medication adherence in type 2 diabetes mellitus (T2DM) improves glycemic control and is associated with reduced adverse clinical events, and accurately assessing adherence assessment is important. We aimed to determine agreement between two com ...
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Journal articleNephrol Dial Transplant · December 2015
BACKGROUND: Ferumoxytol was first approved for clinical use in 2009 solely based on data from trial comparisons with oral iron on biochemical anemia efficacy end points. To compare the rates of important patient outcomes (infection, cardiovascular events a ...
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Journal articleCirc Cardiovasc Genet · December 2015
BACKGROUND: Recent genome-wide association studies have identified 49 single nucleotide polymorphisms associated with clinical coronary artery disease. The mechanism by which these loci influence risk remains largely unclear. METHODS AND RESULTS: We examin ...
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Journal articleJ Adolesc Health · November 2015
PURPOSE: The purpose of the study was to describe inpatient hospitalization patterns among detained and nondetained youth in a large, total population of hospitalized adolescents in California. METHODS: We examined the unmasked California Office of Statewi ...
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Journal articleDrug Alcohol Depend · November 1, 2015
BACKGROUND: Comorbid diabetes and substance use diagnoses (SUD) represent a hazardous combination, both in terms of healthcare cost and morbidity. To date, there is limited information about the association of SUD and related mental disorders with type 2 d ...
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Journal articleJ Biomed Inform · October 2015
Electronic Health Records (EHRs) present the opportunity to observe serial measurements on patients. While potentially informative, analyzing these data can be challenging. In this work we present a means to classify individuals based on a series of measur ...
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Journal articleGenet Epidemiol · September 2015
Genetic risk scores are an increasingly popular tool for summarizing the cumulative risk of a set of Single Nucleotide Polymorphisms (SNPs) with disease. Typically only the set of the SNPs that have reached genome-wide significance compose these scores. Ho ...
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Journal articleAm J Public Health · August 2015
OBJECTIVES: We examined how state characteristics in early life are associated with individual chronic disease later in life. METHODS: We assessed early-life state of residence using the first 3 digits of social security numbers from blue- and white-collar ...
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Journal articleAm J Kidney Dis · July 2015
BACKGROUND: Adequately powered studies directly comparing hard clinical outcomes of darbepoetin alfa (DPO) versus epoetin alfa (EPO) in patients undergoing dialysis are lacking. STUDY DESIGN: Observational, registry-based, retrospective cohort study; we mi ...
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Journal articleBiometrics · June 2015
Featured Publication
Data sources with repeated measurements are an appealing resource to understand the relationship between changes in biological markers and risk of a clinical event. While longitudinal data present opportunities to observe changing risk over time, these ana ...
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Journal articleKidney Int · June 2015
Large population registries present opportunities to understand the epidemiology of disease, study patters of care, and compare the effectiveness of different care practices. While these 'big data' tempt investigators to examine all available individuals, ...
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Journal articleJ Acad Nutr Diet · April 2015
BACKGROUND: Latino immigrants have high rates of obesity and face barriers to weight loss. OBJECTIVE: To evaluate the effectiveness of a case-management (CM) intervention with and without community health workers (CHWs) for weight loss. DESIGN: This was a ...
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Journal articleAm J Transplant · March 2015
Featured Publication
The severe shortage of donor hearts limits the availability of transplantation for the growing population of patients with end-stage heart disease. We examined national trends in donor heart acceptance for transplant. OPTN data were analyzed for all potent ...
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Journal articleNature · February 12, 2015
Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and a ...
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Journal articlePediatrics · February 2015
BACKGROUND AND OBJECTIVES: Examination of regional care patterns in antenatal corticosteroid use (ACU) rates may be salient for the development of targeted interventions. Our objective was to assess network-level variation using California perinatal care r ...
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Journal articleJ Heart Lung Transplant · January 2015
BACKGROUND: Echocardiogram reports, but not images, are usually available for the evaluation of potential donor hearts. To assess the reliability of local reports of potential pediatric heart donors, we compared echocardiographic measurements of left ventr ...
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Journal articlePLoS One · 2015
BACKGROUND: Investigators across many fields often struggle with how best to capture an individual's overall health status, with options including both subjective and objective measures. With the increasing availability of "big data," researchers can now t ...
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Journal articlePLoS One · 2015
BACKGROUND: Our current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In ...
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Journal articleJ Am Coll Cardiol · December 16, 2014
BACKGROUND: Asian Americans are a rapidly growing racial/ethnic group in the United States. Our current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups. OBJECTIVES: The purpose ...
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Journal articleAm J Transplant · October 2014
Implementation of the lung allocation score (LAS) in 2005 led to transplantation of older and sicker patients without altering 1-year survival. However, long-term survival has not been assessed and emphasizing the 1-year survival metric may actually sustai ...
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Journal articleHealth Aff (Millwood) · September 2014
The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young ...
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Journal articlePrev Chronic Dis · July 17, 2014
INTRODUCTION: In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children's meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were ...
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Journal articleJ Am Soc Nephrol · June 2014
The proportion of low-income nonelderly adults covered by Medicaid varies widely by state. We sought to determine whether broader state Medicaid coverage, defined as the proportion of each state's low-income nonelderly adult population covered by Medicaid, ...
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Journal articleJAMA Intern Med · May 2014
IMPORTANCE: Anemia is common in patients with advanced chronic kidney disease. Whereas the treatment of anemia in patients with end-stage renal disease (ESRD) has attracted considerable attention, relatively little is known about patterns and trends in the ...
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Journal articleJAMA · March 12, 2014
IMPORTANCE: Whole-genome sequencing (WGS) is increasingly applied in clinical medicine and is expected to uncover clinically significant findings regardless of sequencing indication. OBJECTIVES: To examine coverage and concordance of clinically relevant ge ...
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Journal articleOccup Environ Med · March 2014
OBJECTIVES: An 'information gap' has been identified regarding the effects of chronic disease on occupational injury risk. We investigated the association of ischaemic heart disease, hypertension, diabetes, depression and asthma with acute occupational inj ...
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Journal articleFront Genet · 2014
Featured Publication
PURPOSE: Genetic risk assessment is becoming an important component of clinical decision-making. Genetic Risk Scores (GRSs) allow the composite assessment of genetic risk in complex traits. A technically and clinically pertinent question is how to most eas ...
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Journal articleClin J Am Soc Nephrol · January 2014
Featured Publication
BACKGROUND AND OBJECTIVES: Sudden cardiac death is the most common cause of death among individuals undergoing hemodialysis. The epidemiology of sudden cardiac death has been well studied, and efforts are shifting to risk assessment. This study aimed to te ...
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Journal articleCell Rep · December 26, 2013
Inhibition of DAF-2 (insulin-like growth factor 1 [IGF-1] receptor) or RSKS-1 (S6K), key molecules in the insulin/IGF-1 signaling (IIS) and target of rapamycin (TOR) pathways, respectively, extend lifespan in Caenorhabditis elegans. However, it has not bee ...
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Journal articleClin J Am Soc Nephrol · December 2013
BACKGROUND AND OBJECTIVES: Hispanic patients undergoing chronic dialysis are less likely to receive a kidney transplant compared with non-Hispanic whites. This study sought to elucidate disparities in the path to receipt of a deceased donor transplant betw ...
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Journal articleCrit Care Med · August 2013
OBJECTIVE: Mortality associated with acute lung injury remains high. Early identification of acute lung injury prior to onset of respiratory failure may provide a therapeutic window to target in future clinical trials. The recently validated Lung Injury Pr ...
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Journal articleClin J Am Soc Nephrol · August 2013
BACKGROUND AND OBJECTIVES: Patients with ESRD experience a fivefold higher incidence of hip fracture than the age- and sex-matched general population. Despite multiple changes in the treatment of CKD mineral bone disorder, little is known about long-term t ...
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Journal articleAm J Kidney Dis · August 2013
BACKGROUND: Hispanic patients undergoing long-term dialysis experience better survival compared with non-Hispanic whites. It is unknown whether this association differs by age, has changed over time, or is due to differential access to kidney transplantati ...
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Journal articleJ Am Coll Cardiol · March 5, 2013
OBJECTIVES: This study sought to ascertain the relationship of 9p21 locus with: 1) angiographic coronary artery disease (CAD) burden; and 2) myocardial infarction (MI) in individuals with underlying CAD. BACKGROUND: Chromosome 9p21 variants have been robus ...
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Journal articleCirc Heart Fail · March 2013
BACKGROUND: Despite a national organ-donor shortage and a growing population of patients with end-stage heart disease, the acceptance rate of donor hearts for transplantation is low. We sought to identify donor predictors of allograft nonuse, and to determ ...
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Journal articlePerit Dial Int · 2013
OBJECTIVES: Switching from peritoneal dialysis (PD) to hemodialysis (HD) is undesirable, because of complications from temporary vascular access, disruption of daily routine, and higher costs. Little is known about the role that social factors play in tech ...
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Journal articleNat Genet · January 2013
Coronary artery disease (CAD) is the commonest cause of death. Here, we report an association analysis in 63,746 CAD cases and 130,681 controls identifying 15 loci reaching genome-wide significance, taking the number of susceptibility loci for CAD to 46, a ...
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Journal articleAm J Transplant · December 2012
Prior studies have demonstrated associations between beta-adrenergic receptor (βAR) polymorphisms and left ventricular dysfunction-an important cause of allograft nonutilization for transplantation. We hypothesized that βAR polymorphisms predispose donor h ...
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Journal articleCirculation · November 6, 2012
BACKGROUND: One sixth of US dialysis patients 65 years of age have been diagnosed with atrial fibrillation/flutter (AF). Little is known, however, about the incidence of AF in this population. METHODS AND RESULTS: We identified 258 605 older patients (≥67 ...
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Journal articleFam Cancer · September 2012
The prevalence and penetrance of BRCA1 and BRCA2 (BRCA1/2) mutations may differ between Asians and whites. We investigated BRCA1/2 mutations and cancer risk factors in a clinic-based sample. BRCA1/2 mutation carriers were enrolled from cancer genetics clin ...
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Journal articleCirc Heart Fail · July 1, 2012
BACKGROUND: Current regulations require that all cardiac allograft offers for transplantation must include an interpreted 12-lead electrocardiogram (ECG). However, little is known about the expected ECG findings in potential organ donors or the clinical si ...
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Journal articleClin J Am Soc Nephrol · February 2012
BACKGROUND AND OBJECTIVES: Hispanics are the largest minority in the United States (comprising 16.3% of the US population) and have 1.5 times the age-, sex-, and race-adjusted incidence of ESRD compared with non-Hispanics. Poor health care access and low-q ...
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Journal articleGenes Immun · December 2011
The major histocompatibility complex (MHC) class II transactivator gene (CIITA) encodes an important transcription factor required for human leukocyte antigens (HLA) class II MHC-restricted antigen presentation. MHC genes, including the HLA class II DRB1*0 ...
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Journal articleGenes Immun · December 2011
Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system with a strong genetic component. Several lines of evidence support a strong role for genetic factors influencing both disease susceptibility and clinical outcome in MS ...
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Journal articleStat Appl Genet Mol Biol · 2011
The Random Forests (RF) algorithm has become a commonly used machine learning algorithm for genetic association studies. It is well suited for genetic applications since it is both computationally efficient and models genetic causal mechanisms well. With i ...
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Journal articleHum Mol Genet · November 1, 2010
The primary genetic risk factor in multiple sclerosis (MS) is the HLA-DRB1*1501 allele; however, much of the remaining genetic contribution to MS has yet to be elucidated. Several lines of evidence support a role for neuroendocrine system involvement in au ...
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Journal articleAm J Epidemiol · July 15, 2010
Multiple sclerosis (MS) is a complex autoimmune disease of the central nervous system with a prominent genetic component. The primary genetic risk factor is the human leukocyte antigen (HLA)-DRB1*1501 allele; however, much of the remaining genetic contribu ...
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Journal articleBMC Genet · June 14, 2010
BACKGROUND: As computational power improves, the application of more advanced machine learning techniques to the analysis of large genome-wide association (GWA) datasets becomes possible. While most traditional statistical methods can only elucidate main e ...
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Journal articleClin Trials · 2010
BACKGROUND AND PURPOSE: The Type 1 Diabetes Genetics Consortium (T1DGC) is an international project whose primary aims are to: (a) discover genes that modify type 1 diabetes risk; and (b) expand upon the existing genetic resources for type 1 diabetes resea ...
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Journal articlePsychooncology · February 2006
The repression/suppression of negative emotions has long been considered detrimental for breast cancer (BC) patients, leading to poor coping, progression of symptoms, and general lower quality of life. Therapies have focused on encouraging the expression o ...
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Journal articleJ Health Psychol · November 2005
Many breast cancer patients find help from on-line self-help groups, consisting of self-directed, asynchronous, bulletin boards. These have yet to be empirically evaluated. Upon joining a group and 6 months later, new members (N=114) to breast cancer bulle ...
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Journal articleJournal of Mental Health · December 1, 2003
Background: There is a growing trend to view depression as a biological illness rather than a psychosocial condition, even though there is no consensus as to what causes depression. Furthermore, there are mixed data on the impact of advocating the biologic ...
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