Publications by authors named "D M Yealy"
Introduction: Child abuse is a leading cause of morbidity and mortality in children. The rate of missed child abuse in general emergency departments (ED), where 85% of children are evaluated, is higher than in pediatric EDs. We sought to evaluate the impact of an electronic health record (EHR)-embedded child-abuse clinical decision support system (CA-CDSS) in the identification and evaluation of child maltreatment in a network of EDs three years after implementation.
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- Despite previous trials, it's still unclear how to effectively resuscitate patients with septic shock, prompting a deeper look into individual differences in treatment responses.
- The study utilized machine learning to predict individual patient risk differences and evaluate how their characteristics affected treatment effectiveness across two large cohorts.
- Results indicated significant variability in treatment responses; patients predicted to have the highest risks improved with early goal-directed therapy (EGDT), while those at lower risk potentially faced harm from the same treatment.
Objective: We evaluated the impact of a telemedicine bridge clinic on treatment outcomes and cost for patients with opioid use disorder. Telemedicine bridge clinics deliver low-barrier rapid assessment of patients with opioid use disorder via audio-only and audiovisual telemedicine to facilitate induction on medication therapy and connection to ongoing care.
Methods: A pre-post analysis of UPMC Health Plan member claims was performed to evaluate the impact of this intervention on the trajectory of care for patients with continuous coverage before and after bridge clinic visit(s).
Article Synopsis
- The study analyzes sepsis phenotypes using clinical and protein biomarker data from the ProCESS trial, finding two distinct phenotypes based on 20 variables.
- Phenotype 1 (12% of patients) showed higher levels of inflammation and organ dysfunction, leading to significantly higher 60-day inpatient mortality compared to Phenotype 2 (88% of patients).
- The effectiveness of early, goal-directed therapy (EGDT) versus usual care also varied by phenotype, with EGDT performing poorly in Phenotype 1 but similarly to usual care in Phenotype 2.