Publications by authors named "Evan Minty"
Introduction: Acute kidney injury (AKI) is common in the perioperative setting and associated with poor outcomes. Whether clinical decision support improves early management and outcomes of AKI on surgical units is uncertain.
Methods: In this cluster-randomized, stepped-wedge trial, 8 surgical units in Alberta, Canada were randomized to various start dates to receive an education and clinical decision support intervention for recognition and early management of AKI.
Article Synopsis
- This study compares the cardiovascular effectiveness of different second-line antihyperglycemic agents (SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, and sulfonylureas) in patients with type 2 diabetes and cardiovascular disease.
- Using data from over 1.4 million patients across multiple databases, the researchers analyzed the risk of major adverse cardiovascular events (MACE) over a follow-up period of several years.
- Results indicated that SGLT2 inhibitors and GLP-1 receptor agonists had significantly lower risks of MACE compared to DPP-4 inhibitors and sulfonylureas, pointing to their potential superiority as treatment options for
Introduction: Diabetic foot ulcers (DFU) are a devastating complication of diabetes. There are numerous challenges with preventing diabetic foot complications and barriers to achieving the care processes suggested in established foot care guidelines. Multi-faceted digital health solutions, which combine multimodal sensing, patient-facing biofeedback, and remote patient monitoring (RPM), show promise in improving our ability to understand, prevent, and manage DFUs.
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- The study aimed to evaluate how often kidney failure occurs in patients receiving intravitreal anti-VEGF treatments and to compare the risks associated with three specific drugs: ranibizumab, aflibercept, and bevacizumab.
- Researchers conducted a retrospective cohort study, analyzing data from 12 databases within the OHDSI network, focusing on patients over 18 with retinal diseases receiving these treatments.
- Results showed an average incidence of kidney failure of 678 per 100,000 persons, and no significant differences in risk were found among the three anti-VEGF drugs, indicating similar safety profiles regarding kidney health.
Article Synopsis
- * The study analyzed data from over 1.4 million patients treated with various second-line diabetes medications, using advanced statistical methods to compare outcomes and risks of heart issues.
- * Findings indicated that both SGLT2 inhibitors and GLP-1 receptor agonists reduce the risk of cardiovascular events compared to DPP-4 inhibitors and sulfonylureas, but no significant differences were found between SGLT2is and GLP1-RAs themselves regarding heart risks.
Article Synopsis
- The manuscript focuses on real-world evidence (RWE) in pulmonary hypertension (PH), involving experts from the Pulmonary Vascular Research Institute.
- The goal is to enhance the research community's understanding of RWE to advance clinical research and improve patient care for those with PH.
- The text reviews sources of real-world data (RWD), highlights challenges and opportunities in using RWD for PH research, and identifies necessary resources to generate impactful RWE for the global PH community.
Article Synopsis
- The study aimed to evaluate the adoption of second-line antihyperglycaemic medications among type 2 diabetes patients using metformin, analyzing data from 10 US and 7 international health databases.
- A total of 4.8 million participants were included, focusing on the trends in initiating additional diabetes treatments over the years 2011 to 2021.
- Results showed significant growth in the use of cardioprotective drugs (like GLP-1 receptor agonists and SGLT2 inhibitors) as second-line options, with initiation rates varying widely across countries and databases.
Diabetes and its complications, particularly diabetic foot ulcers (DFUs), pose significant challenges to healthcare systems worldwide. DFUs result in severe consequences such as amputation, increased mortality rates, reduced mobility, and substantial healthcare costs. The majority of DFUs are preventable and treatable through early detection.
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- Vaccine safety surveillance often uses a combination of different testing methods, but it's unclear how effective this serial testing approach is in terms of accuracy and error rates.
- This study examined the performance of serial testing across various databases by looking at different types of errors before and after improving the testing methods, particularly focusing on two designs: historical comparator and self-controlled case series (SCCS).
- The findings revealed that while combining methods reduced false positives, it led to a higher number of false negatives, suggesting that simpler, single-design approaches may be more effective for accurately identifying vaccine safety signals.
Article Synopsis
- The study addresses challenges in selecting computational phenotypes for research by proposing a novel metadata framework to improve retrieval and reuse of these phenotypes.
- Twenty active researchers contributed to identifying 39 relevant metadata elements, which were then evaluated through surveys and annotation tasks involving type-2 diabetes mellitus phenotypes.
- Results showed over 90% satisfaction with the framework's utility, highlighting effectiveness in phenotype description and validation, while noting challenges in data collection complexity and associated costs.
Patients diagnosed with systemic lupus erythematosus (SLE) suffer from a decreased quality of life, an increased risk of medical complications, and an increased risk of death. In particular, approximately 50% of SLE patients progress to develop lupus nephritis, which oftentimes leads to life-threatening end stage renal disease (ESRD) and requires dialysis or kidney transplant. The challenge is that lupus nephritis is diagnosed via a kidney biopsy, which is typically performed only after noticeable decreased kidney function, leaving little room for proactive or preventative measures.
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- The study aimed to compare the incidence rates of adverse events of special interest (AESIs) following COVID-19 infection with historical rates in the general population, focusing on 16 specific health outcomes.
- Researchers conducted a multinational cohort study using diverse health data from 2017 to 2022 and found that post-COVID-19 AESIs were consistently more common, with significant variations based on age and population demographics.
- The findings indicated that thromboembolic events, like pulmonary embolism, were particularly prevalent after a COVID-19 infection, highlighting the need for further research on long-term complications related to the virus.
Article Synopsis
- This study investigates how different interpretations of an observational study's design can affect the results when independent researchers attempt to reproduce it.
- The researchers found that out of ten criteria for including patients, teams only agreed, on average, 4 of 10 times, leading to significant variability in the size and characteristics of the resulting patient cohorts.
- The study concludes that providing open analytical code and a standardized data model can improve reproduction accuracy and consistency in observational research.
Article Synopsis
- The text is a correction to a previously published article with the DOI 10.3389/fphar.2022.893484.
- It addresses errors or inaccuracies found in that article, which may affect the interpretation of the research findings.
- Such corrections are important for maintaining the integrity and accuracy of scientific literature.
Background: Understanding physician leadership is critical during pandemics and other health crises when formal organisational leaders may be unable to respond expeditiously. This study examined how physician leaders managed to quickly design a new model for acute-care physicians' work, adopted across four large hospitals in a public health authority in Canada during the COVID-19 pandemic.
Methods: The research employed a qualitative case study methodology, with inductive analysis of interview transcripts and documents.
Article Synopsis
- Routinely collected healthcare data can help identify unknown risks of vaccines, but uncertainty exists regarding the best epidemiologic designs for early detection of these risks.
- The study evaluates various methods, like case-control and cohort designs, using both real and simulated outcomes, finding that many methods tend to report false positives (high type 1 error).
- The self-controlled case series design is most effective in quickly identifying small true effects, while the historical comparator is better for detecting stronger effects; however, careful consideration of potential systematic errors is necessary for accurate results.
Article Synopsis
- - Vaccine-induced thrombotic thrombocytopenia (VITT) is a serious but rare side effect linked to COVID-19 vaccines, prompting researchers to study pre-pandemic cases of thrombosis with thrombocytopenia (TWT) using global health data sources.
- - The study analyzed electronic health records from 2017 to 2019 to determine background rates of TWT, which were found to vary significantly across different demographics and definitions, with incidence rates ranging from 1.62 to 150.65 per 100,000 person-years.
- - Results indicated that TWT patients tend to be older men with various health issues, and the research suggests challenges in identifying VITT due to inconsistent baseline characteristics compared to
Article Synopsis
- The study emphasizes the importance of real world data (RWD) for understanding and responding to the COVID-19 pandemic using a standardized approach through the CHARYBDIS framework.
- Researchers conducted a retrospective database study across multiple countries, including the US and parts of Europe and Asia, involving over 4.5 million individuals and focusing on their clinical characteristics and outcomes.
- Findings reveal higher diagnoses among women but more hospitalizations among men, common comorbidities like diabetes and heart disease, and key symptoms such as cough and fever; this data helps to identify trends in COVID-19 across different populations and time periods.
Article Synopsis
- A study analyzed clinical characteristics of COVID-19 patients with asthma using data from nine international databases from January to June 2020.
- Among the diagnosed cohort of 666,933, asthma prevalence ranged from 6.2% to 18.5%, and in the hospitalized cohort of 159,552, it ranged from 5.2% to 20.5%.
- The study found that asthma patients had high rates of comorbidities, with mortality rates similar to those without asthma, while asthma exacerbation at presentation was relatively low.
Article Synopsis
- A large-scale study was conducted to evaluate the bias, precision, and timeliness of different designs in estimating vaccine safety events by comparing expected rates with observed rates post-vaccination.
- The analysis revealed that using historical background rates to identify potential safety signals for vaccines was sensitive but often overestimated risks, showing high type 1 error (20%-100%) and low type 2 error (0%-20%).
- Adjusting for factors like age and sex improved the accuracy but still left some systematic errors, while empirical calibration helped reduce type 1 error though at the expense of increasing type 2 error.
Multi-center observational studies require recognition and reconciliation of differences in patient representations arising from underlying populations, disparate coding practices and specifics of data capture. This leads to different granularity or detail of concepts representing the clinical facts. For researchers studying certain populations of interest, it is important to ensure that concepts at the right level are used for the definition of these populations.
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- The study aimed to assess the 30-day outcomes and mortality of patients with autoimmune diseases hospitalized due to COVID-19, comparing them to similar hospital patients with seasonal influenza.
- Researchers analyzed data from multiple health institutions and found that most patients were older females with significant comorbidities.
- Results indicated that COVID-19 led to more respiratory complications and higher mortality rates (up to 24.6%) compared to influenza (up to 4.3%).
Article Synopsis
- Routinely collected real-world data (RWD) is essential for understanding and responding to the COVID-19 pandemic, as demonstrated by the CHARYBDIS framework for standardizing and analyzing this data.
- A descriptive cohort study involving over 4.5 million individuals was conducted across the U.S., Europe, and Asia to examine COVID-19-related health risks and outcomes, with detailed information available on an interactive website.
- The findings from the CHARYBDIS study serve as benchmarks to enhance our knowledge of COVID-19's progression and management, facilitating timely evaluations of new preventative and therapeutic strategies.
Background: The evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems.
Intervention: The Medical Emergency-Pandemic Operations Command (MEOC)-a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada-partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals.
Article Synopsis
- A study investigated the 30-day outcomes and mortality of patients with autoimmune diseases hospitalized due to COVID-19, highlighting increased complications compared to those admitted for seasonal influenza.
- The research used electronic health records from various healthcare institutions across the U.S. and Spain, analyzing data from over 133,000 COVID-19 patients and similar influenza patients.
- Results showed that COVID-19 patients with autoimmune diseases experienced higher rates of respiratory issues and significantly increased 30-day mortality rates, indicating poorer outcomes compared to those with influenza.