Using stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway.

Identifying alternatives to acute hospital admission is a priority for many countries. Over 200 decentralised municipal acute units (MAUs) were established in Norway to divert low-acuity patients away from hospitals. MAUs have faced criticism for low mean occupancy and not relieving pressures on hospitals.

Prediction of occult atrial fibrillation in patients after cryptogenic stroke and transient ischaemic attack: PROACTIA.

Aims: Studies with implantable cardiac monitors (ICMs) show that one-third of patients with cryptogenic stroke/transient ischaemic attack (TIA) have episodes of subclinical atrial fibrillation (SCAF) and benefit switching from antiplatelet- to anticoagulant therapy. However, ICMs are costly and resource demanding. We aimed to build a score based on participant's baseline characteristics that could assess individual risk of SCAF.

Stroke unit demand in Norway - present and future estimates.

Background: All stroke patients should receive timely admission to a stroke unit (SU). Consequently, most patients with suspected strokes - including stroke mimics (SM) are admitted. The aim of this study was to estimate the current total demand for SU bed capacity today and give estimates for future (2020-2040) demand.

Stroke Mimics on the Stroke Unit - Temporal trends 2008-2017 at a large Norwegian university hospital.

Objectives: The objective was to quantify temporal trends in stroke mimics (SM) admissions relative to cerebrovascular accidents (CVA), incidence of hospitalized SMs and characterize the SM case-mix at a general hospital's stroke unit (SU).

Materials & Methods: All SU admissions (n = 11240) of patients aged 15 or older to Haukeland University Hospital between 2008-2017 were prospectively included and categorized as CVA or SM. Logistic regression was used to estimate time trends in the proportion of SMs among the admissions.

Long-term prognosis for patients admitted to a medical intermediate care unit.

Background: The intermediate care unit at Akershus University Hospital treats patients with incipient or manifest organ failure. Selecting patients who might benefit from treatment in an intermediate care unit is challenging. Few data are available on long-term survival of patients treated in medical intermediate care units and on how assumed favourable and unfavourable prognostic factors predict long-term survival in this population.

Neural classification of Norwegian radiology reports: using NLP to detect findings in CT-scans of children.

Background: With a motivation of quality assurance, machine learning techniques were trained to classify Norwegian radiology reports of paediatric CT examinations according to their description of abnormal findings.

Methods: 13.506 reports from CT-scans of children, 1000 reports from CT scan of adults and 1000 reports from X-ray examination of adults were classified as positive or negative by a radiologist, according to the presence of abnormal findings.

No Correlation Between Ethical Judgment in Trolley Dilemmas and Vaccine Scenarios for Nurse Specialist Students.

We tested whether responses to trolley problems by nurse specialist students correlated with their responses to hypothetical vaccine problems, as a follow-up to a similar study on ethics committees. No statistically significant correlation was found between the trolley and vaccination scores. These results confirmed and strengthened the finding of a very weak correlation (possibly zero), and the point estimate was even lower than for the ethics committees.

A Markov chain method for counting and modelling migraine attacks.

To ensure reproducibility in research quantifying episodic migraine attacks, and identifying attack onset, a sound theoretical model of a migraine attack, paired with a uniform standard for counting them, is necessary. Many studies report on migraine frequencies-e.g.

Capacity and patient flow planning in post-term pregnancy outpatient clinics: a computer simulation modelling study.

Background: The demand for a large Norwegian hospital's post-term pregnancy outpatient clinic has increased substantially over the last 10 years due to changes in the hospital's catchment area and to clinical guidelines. Planning the clinic is further complicated due to the high did not attend rates as a result of women giving birth. The aim of this study is to determine the maximum number of women specified clinic configurations, combination of specified clinic resources, can feasibly serve within clinic opening times.

Surgical site infection after hip fracture - mortality and risk factors: an observational cohort study of 1,709 patients.

Background and purpose - Surgical site infection (SSI) is a devastating complication of hip fracture surgery. We studied the contribution of early deep SSI to mortality after hip fracture surgery and the risk factors for deep SSI with emphasis on the duration of surgery.Patients and methods - 1,709 patients (884 hemi-arthroplasties, 825 sliding hip screws), operated from 2012 to 2015 at a single center were included.

Erlang could have told you so-A case study of health policy without maths.

Little consideration is given to the operational reality of implementing national policy at local scale. Using a case study from Norway, we examine how simple mathematical models may offer powerful insights to policy makers when planning policies. Our case study refers to a national initiative requiring Norwegian municipalities to establish acute community beds (municipal acute units or MAUs) to avoid hospital admissions.

Fewer ischemic strokes, despite an ageing population: stroke models from observed incidence in Norway 2010-2015.

Background: Stroke incidence rates have fallen in high-income countries over the last several decades, but findings regarding the trend over recent years have been mixed. The aim of the study was to describe and model temporal trends in incidence of stroke by age and sex between 2010 and 2015 in Norway, and to generate incidence projections towards year 2040.

Methods: All recorded strokes in Norway between 2010 and 2015 were extracted from the National Patient Registry and the National Cause of Death Registry.

Identifying menstrual migraine- improving the diagnostic criteria using a statistical method.

Objective: To develop a robust statistical tool for the diagnosis of menstrually related migraine.

Background: The International Classification of Headache Disorders (ICHD) has diagnostic criteria for menstrual migraine within the appendix. These include the requirement for menstrual attacks to occur within a 5-day window in at least [Formula: see text] menstrual cycles ([Formula: see text]-criterion).

Fast track hip fracture care and mortality - an observational study of 2230 patients.

Background: Hip fracture patients are frail and have a high mortality. We investigated whether the introduction of fast track care reduced the 30-day mortality after hip fractures.

Methods: Fast track hip fracture care was established at our institution in October 2013.

Trolley Dilemmas Fail to Predict Ethical Judgment in a Hypothetical Vaccination Context.

We investigated whether the responses of 68 ethics committee members and staff to trolley dilemmas could predict their responses to research ethics problems concerning vaccine trials. Trolley dilemmas deal with the issue of sacrificing some for the benefit of many, which is also a core issue in the vaccination trial dilemmas. The subjects' responses to trolley dilemmas showed no statistically significant correlation with their responses to our vaccination trial dilemmas.

Stroke incidence in the young: evidence from a Norwegian register study.

Introduction: While there is a general agreement that stroke incidence among the elderly is declining in the developed world, there is a concern that it may be increasing among the young. The present study investigates this issue for the Norwegian population for the years 2010-2015. Cerebrovascular accidents (CVAs) for patients younger than 55 years were identified through the Norwegian Patient Registry and the Norwegian Cause-of-death Registry.

The Burden of Stroke Mimics: Present and Future Projections.

Background And Purpose: An increasing proportion of patients presenting with suspected stroke prove to have other conditions, often referred to as stroke mimics. The aim of this study was to present a projection of the number of hospitalized strokes, transient ischemic attacks (TIAs), and stroke mimics in Norway up to the year 2050 based on expected demographic changes, to estimate the burden of stroke mimics in the coming decades.

Materials And Methods: This prospective study included all admissions to the stroke unit of Akershus University Hospital from March 1, 2012, to February 28, 2013.

Pre-contact by telephone increases response rates to postal questionnaires in a population of stroke patients: an open ended randomized controlled trial.

Background: A follow-up study on a cohort of stroke patients through a postal survey questionnaire 3 and 12 months after discharge from hospital was performed. The response rate at 3-months follow-up was lower than desired, and pre-contact by phone as a measure for increasing the response rate at 12 months was studied.

Methods: The study design was a randomized controlled trial on a cohort of 3 months follow-up-non-responders where the intervention group was pre-contacted with an aim to obtain an informal 'consent to receive' the questionnaire before the 12-months survey was mailed, and the control group was not.

Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports.

Background: Misinterpretation of radiological examinations is an important contributing factor to diagnostic errors. Consultant radiologists in Norwegian hospitals frequently request second reads by colleagues in real time. Our objective was to estimate the frequency of clinically important changes to radiology reports produced by these prospectively obtained double readings.

Double reading of current chest CT examinations: Clinical importance of changes to radiology reports.

Objectives: Misinterpretation of radiological examinations is an important contributing factor to diagnostic errors. Double reading reduces interpretation errors and increases sensitivity. Consultant radiologists in Norwegian hospitals submit 39% of computed tomography (CT) reports for quality assurance by double reading.

Laparoscopic Lavage vs Primary Resection for Acute Perforated Diverticulitis: The SCANDIV Randomized Clinical Trial.

Importance: Perforated colonic diverticulitis usually requires surgical resection, which is associated with significant morbidity. Cohort studies have suggested that laparoscopic lavage may treat perforated diverticulitis with less morbidity than resection procedures.

Objective: To compare the outcomes from laparoscopic lavage with those for colon resection for perforated diverticulitis.

Statistical testing of association between menstruation and migraine.

Objective: To repair and refine a previously proposed method for statistical analysis of association between migraine and menstruation.

Background: Menstrually related migraine (MRM) affects about 20% of female migraineurs in the general population. The exact pathophysiological link from menstruation to migraine is hypothesized to be through fluctuations in female reproductive hormones, but the exact mechanisms remain unknown.