Background: Machine Learning (ML) models often struggle to generalize effectively to data that deviates from the training distribution. This raises significant concerns about the reliability of real-world healthcare systems encountering such inputs known as out-of-distribution (OOD) data. These concerns can be addressed by real-time detection of OOD inputs.
View Article and Find Full Text PDFPurpose: Parametric regression models have been the main statistical method for identifying average treatment effects. Causal machine learning models showed promising results in estimating heterogeneous treatment effects in causal inference. Here we aimed to compare the application of causal random forest (CRF) and linear regression modelling (LRM) to estimate the effects of organisational factors on ICU efficiency.
View Article and Find Full Text PDFBackground: Federated learning (FL) is a technique for learning prediction models without sharing records between hospitals. Compared to centralized training approaches, the adoption of FL could negatively impact model performance.
Aim: This study aimed to evaluate four types of multicenter model development strategies for predicting 30-day mortality for patients undergoing transcatheter aortic valve implantation (TAVI): (1) , learning one model from a centralized dataset of all hospitals; (2) , learning one model per hospital; (3) (), averaging of local model coefficients; and (4) , aggregating local model predictions.
Background: Patients' missed appointments can cause interference in the functions of the clinics and the visit of other patients. One of the most effective strategies to solve the problem of no-show rate is the use of an open access scheduling system (OA). This systematic review was conducted with the aim of investigating the impact of OA on the rate of no-show of patients in outpatient clinics.
View Article and Find Full Text PDFBackground: Prediction models can identify fall-prone individuals. Prediction models can be based on either data from research cohorts (cohort-based) or routinely collected data (RCD-based). We review and compare cohort-based and RCD-based studies describing the development and/or validation of fall prediction models for community-dwelling older adults.
View Article and Find Full Text PDFIntroduction: Prolonged Length of Stay (LOS) in ED (Emergency Department) has been associated with poor clinical outcomes. Prediction of ED LOS may help optimize resource utilization, clinical management, and benchmarking. This study aims to systematically review models for predicting ED LOS and to assess the reporting and methodological quality about these models.
View Article and Find Full Text PDFBackground: Falls involve dynamic risk factors that change over time, but most studies on fall-risk factors are cross-sectional and do not capture this temporal aspect. The longitudinal clinical notes within electronic health records (EHR) provide an opportunity to analyse fall risk factor trajectories through Natural Language Processing techniques, specifically dynamic topic modelling (DTM). This study aims to uncover fall-related topics for new fallers and track their evolving trends leading up to falls.
View Article and Find Full Text PDFRahmatinejad Z, Hoseini B, Pourmand A, Reihani H, Rahmatinejad F, Eslami S, Author Response. Indian J Crit Care Med 2024;28(2):183-184.
View Article and Find Full Text PDFBackground: Drug-drug interactions (DDIs) can harm patients admitted to the intensive care unit (ICU). Yet, clinical decision support systems (CDSSs) aimed at helping physicians prevent DDIs are plagued by low-yield alerts, causing alert fatigue and compromising patient safety. The aim of this multicentre study was to evaluate the effect of tailoring potential DDI alerts to the ICU setting on the frequency of administered high-risk drug combinations.
View Article and Find Full Text PDFArch Dis Child Fetal Neonatal Ed
February 2024
Objective: This randomised study in preterm infants on non-invasive respiratory support investigated the effectiveness of automated oxygen control (A-FiO) in keeping the oxygen saturation (SpO) within a target range (TR) during a 28-day period compared with manual titration (M-FiO).
Design: A single-centre randomised control trial.
Setting: A level III neonatal intensive care unit.
Background: Falls are the leading cause of injury-related mortality and hospitalization among adults aged ≥ 65 years. An important modifiable fall-risk factor is use of fall-risk increasing drugs (FRIDs). However, deprescribing is not always attempted or performed successfully.
View Article and Find Full Text PDFBr J Clin Pharmacol
January 2024
Aims: Knowledge about adverse drug events caused by drug-drug interactions (DDI-ADEs) is limited. We aimed to provide detailed insights about DDI-ADEs related to three frequent, high-risk potential DDIs (pDDIs) in the critical care setting: pDDIs with international normalized ratio increase (INR ) potential, pDDIs with acute kidney injury (AKI) potential, and pDDIs with QTc prolongation potential.
Methods: We extracted routinely collected retrospective data from electronic health records of intensive care units (ICUs) patients (≥18 years), admitted to ten hospitals in the Netherlands between January 2010 and September 2019.
Purpose: Personal continuity between patient and physician is a core value of primary care. Although previous studies suggest that personal continuity is associated with fewer potentially inappropriate prescriptions, evidence on continuity and prescribing in primary care is scarce. We aimed to determine the association between personal continuity and potentially inappropriate prescriptions, which encompasses potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), by family physicians among older patients.
View Article and Find Full Text PDFHeliyon
June 2023
Background: Various mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) have been developed in the past years. The effect of time on the performance of such models, however, is unclear given the improvements in the procedure and changes in patient selection, potentially jeopardizing the usefulness of the prediction models in clinical practice. We aim to explore how time affects the performance and stability of different types of prediction models of 30-day mortality after TAVI.
View Article and Find Full Text PDFStud Health Technol Inform
June 2023
Acute kidney injury (AKI) is an abrupt decrease in kidney function widespread in intensive care. Many AKI prediction models have been proposed, but only few exploit clinical notes and medical terminologies. Previously, we developed and internally validated a model to predict AKI using clinical notes enriched with single-word concepts from medical knowledge graphs.
View Article and Find Full Text PDFObjectives: Before being used in clinical practice, a prediction model should be tested in patients whose data were not used in model development. Previously, we developed the ADFICE_IT models for predicting any fall and recurrent falls, referred as Any_fall and Recur_fall. In this study, we externally validated the models and compared their clinical value to a practical screening strategy where patients are screened for falls history alone.
View Article and Find Full Text PDFBackground: Gestational age is positively associated with cognitive development, but socio-demographic factors also influence school performance. Previous studies suggested possible interaction, putting children with low socio-economic status (SES) at increased risk of the negative effects of prematurity.
Objectives: To investigate the association between gestational age in weeks, socio-demographic characteristics, and school performance at the age of 12 years among children in regular primary education.
Background: A comparison of emergency residents' judgments and two derivatives of the Sequential Organ Failure Assessment (SOFA), namely, the mSOFA and the qSOFA, was conducted to determine the accuracy of predicting in-hospital mortality among critically ill patients in the emergency department (ED).
Methods: A prospective cohort research was performed on patients over 18 years of age presented to the ED. We used logistic regression to develop a model for predicting in-hospital mortality by using qSOFA, mSOFA, and residents' judgment scores.