Remarkable advances in high-throughput sequencing have enabled major biological discoveries and clinical applications, but achieving wider distribution and use depends critically on further improvements in scale and cost reduction. Nanopore sequencing has long held the promise for such progress, but has had limited market penetration. This is because efficient and accurate nanopore sequencing of nucleic acids has been challenged by fundamental signal-to-noise limitations resulting from the poor spatial resolution and molecular distinction of nucleobases.
View Article and Find Full Text PDFBackground: New federal mandates require universal screening and referral for social determinants of health (SDOHs), and evidence exists supporting its integration into primary care practice. However, implementation in maternity care remains understudied and underfunded. To inform maternal health practice, we studied clinical stakeholders' perspectives on SDOH screening and referral knowledge, priority, challenges, and opportunities across four hospital-affiliated obstetrics and gynecology clinics in New Hampshire.
View Article and Find Full Text PDFIntroduction: Military Health System (MHS)-insured newborns receive care in military and civilian hospitals. Differences in delivery location and corresponding payment schemas raise questions regarding possible health system effects on utilization and outcomes. We hypothesize that newborn utilization and clinical outcomes differ between military and civilian hospitals and that the differences may be more pronounced among lower risk newborns (i.
View Article and Find Full Text PDFImportance: Accurate identification of hospital readmission risk during a current hospitalization may enhance decision-making, facilitate targeted systems-level interventions, and avoid preventable readmissions.
Objective: To temporally and externally validate a suite of readmission risk prediction models across 48 children's hospitals to assess their generalizability and feasibility for future clinical implementation.
Design, Setting, And Participants: This prognostic study analyzed data from the Pediatric Health Information System (PHIS) database, which contains billing and resource use data from 48 US children's hospitals, including the derivation hospital (DH) and 47 hospitals participating in the PHIS database (hereafter other PHIS hospitals).
Objective: To examine rural-urban differences in the clinician workforce caring for children with medical complexity (CMC) in ambulatory settings and to determine how measures of clinician patient-sharing differ for rural- and urban-residing CMC.
Study Design: We analyzed Massachusetts, New Hampshire, and Colorado all-payer claims data from 2012 through 2017 to identify CMC and their clinicians. We assembled patient-sharing networks in which clinicians were connected on the basis of having encounters with common pediatric patients.