Inferring medication adherence from time-varying health measures.

Medication adherence is a problem of widespread concern in clinical care. Poor adherence is a particular problem for patients with chronic diseases requiring long-term medication because poor adherence can result in less successful treatment outcomes and even preventable deaths. Existing methods to collect information about patient adherence are resource-intensive or do not successfully detect low-adherers with high accuracy.

Impact of Case-Mix Measurement Error on Estimation and Inference in Profiling of Health Care Providers.

Profiling analysis aims to evaluate health care providers by modeling each provider's performance with respect to a patient outcome, such as unplanned hospital readmission. High-dimensional regression models are used in profiling to risk-adjust for patient case-mix covariates. Case-mix covariates typically ascertained from administrative databases are inherently error-prone.

Measuring effects of medication adherence on time-varying health outcomes using Bayesian dynamic linear models.

One of the most significant barriers to medication treatment is patients' non-adherence to a prescribed medication regimen. The extent of the impact of poor adherence on resulting health measures is often unknown, and typical analyses ignore the time-varying nature of adherence. This article develops a modeling framework for longitudinally recorded health measures modeled as a function of time-varying medication adherence.

Performance Characteristics of Profiling Methods and the Impact of Inadequate Case-mix Adjustment.

Profiling or evaluation of health care providers involves the application of statistical models to compare each provider's performance with respect to a patient outcome, such as unplanned 30-day hospital readmission, adjusted for patient case-mix characteristics. The nationally adopted method is based on random effects (RE) hierarchical logistic regression models. Although RE models are sensible for modeling hierarchical data, novel high dimensional fixed effects (FE) models have been proposed which may be well-suited for the objective of identifying sub-standard performance.

Bias and estimation under misspecification of the risk period in self-controlled case series studies.

The self-controlled case series (SCCS) method is useful for estimating the relative incidence (RI) of acute events, such as adverse events (AEs) during a specified risk period following an exposure (e.g., 6-week period after vaccinations or 30-day period after infection-related hospitalizations).

The relationship between Taekwondo training habits and injury: a survey of a collegiate Taekwondo population.

Objective: To correlate training habits of Taekwondo (TKD) athletes to risk for injury.

Background: TKD is a Korean marital art that has been growing in popularity, with nearly 2 million individuals practicing the sport in the United States. Because of the combative nature of the sport, injuries are an inherent risk.

Oxidized low-density lipoprotein, matrix-metalloproteinase-8 and carotid atherosclerosis in spinal cord injured subjects.

Objective: Previous reports have indicated that subjects with chronic spinal cord injury (SCI) exhibit increased cardiovascular risk compared to able-bodied individuals. This study investigated the relationship between plasmatic oxidized low-density lipoprotein (OxLDL), matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) levels and vascular remodeling in SCI subjects and the role of physical activity in this regard.

Methods: We studied 42 men with chronic (≥2 years) SCI [18 sedentary (S-SCI) and 24 physically active (PA-SCI)] and 16 able-bodied men by clinical, anthropometric, laboratory, and carotid intima-media thickness (IMT) analysis.

Physical activity and improved diastolic function in spinal cord-injured subjects.

Purpose: Subjects with spinal cord injury (SCI) have been reported to present impaired left ventricular (LV) diastolic function in comparison with able-bodied (AB) ones. The present study investigated the effect of regular physical activity on the cardiac structure and function of SCI subjects.

Methods: Fifty-eight SCI men (29 sedentary [SCI-S] and 29 athletes [SCI-A]) and 29 AB men were cross-sectionally evaluated by clinical, laboratory, hemodynamic, and echocardiographic analysis.

Automatic flow system for simultaneous determination of iron and chromium in steel alloys employing photometers based on LEDs as radiation source.

A multicommutated flow system for simultaneous determination of iron and chromium in steel alloys by photometry is described. The flow network consisted of an automatic injector and four solenoid valves assembled to form two independent analytical pathways, each one comprising reaction coils and a flow cell. The light source (LED) and detector (photodiode) were attached to the flow cells to form a compact unit.