A prediction model for asthma exacerbations after stopping asthma biologics.

Background: Little is known regarding the prediction of the risks of asthma exacerbation after stopping asthma biologics.

Objective: To develop and validate a predictive model for the risk of asthma exacerbations after stopping asthma biologics using machine learning models.

Methods: We identified 3057 people with asthma who stopped asthma biologics in the OptumLabs Database Warehouse and considered a wide range of demographic and clinical risk factors to predict subsequent outcomes.

Asthma biologic trial eligibility and real-world outcomes in the United States.

Objective: To compare the outcomes of real-world patients who would have been eligible for asthma biologics to those who would not have been eligible.

Methods: We used data from the OptumLabs Data Warehouse (OLDW) to categorize patients into eligible and ineligible groups based on clinical trials ( = 19 trials) used for Food and Drug Administration (FDA) approval. We then compared the change in the number of asthma exacerbations before and after biological initiation between the two groups.

Persistence of asthma biologic use in a US claims database.

Background: Little is known on the persistence of asthma biologic use in clinical practice.

Objective: To evaluate the persistence of asthma biologic use and time to clinical response in clinical practice.

Methods: A cohort of people with asthma who used at least 1 asthma biologic was constructed using data from 2003 to 2019 in the OptumLabs Data Warehouse.

Asthma Patients Who Stop Asthma Biologics Have a Similar Risk of Asthma Exacerbations as Those Who Continue Asthma Biologics.

Background: There is limited information about outcomes associated with stopping asthma biologics.

Objective: To compare outcomes in people who stopped or continued asthma biologics.

Methods: We identified a cohort of people with asthma who stopped or continued asthma biologics in the Optum Labs Database Warehouse, using a propensity matching method for case and control groups with the variables of age, sex, race, region, insurance, income, specialist access, Charlson comorbidity, specific medical conditions, pre-index exacerbation count, pre-index rescue inhaler pharmacy fills, and pre-index inhaled corticosteroid with or without long-acting β-agonist pharmacy fills.

Adherence to Asthma Biologics: Implications for Patient Selection, Step Therapy, and Outcomes.

Background: Little is known about adherence to asthma biologics.

Research Question: Is adherence to inhaled corticosteroid (ICS) associated with subsequent asthma biologic adherence?

Study Design And Methods: We analyzed individuals with asthma who started asthma biologics in the OptumLab Data Warehouse and used that data until October 2019. We calculated proportion days covered (PDC) for ICS ± long-acting β-agonists in the 6 months before and after asthma biologics were started and asthma biologic PDC for the first 6 months of use.

Assessment of automated clinical trial recruitment and enrolment using patient-facing technology.

Objective: Interactive patient care systems (IPCS) at the bedside are becoming increasingly common, but evidence is limited as to their potential for innovative clinical trial implementation. The objective of this study was to test the hypothesis that the IPCS could feasibly be used to automate recruitment and enrolment for a clinical trial.

Methods: In medical-surgical units, we used the IPCS to randomise, recruit and consent eligible subjects.

Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.

Clinical pathways (operational versions of practice guidelines) can improve guideline adherence and quality of care for children hospitalized with asthma. However, there is limited guidance on how to implement pathways successfully. Our objective was to identify potential best practices in pathway implementation.

Limitations of Using Pediatric Respiratory Illness Readmissions to Compare Hospital Performance.

Background: Adult hospital readmission rates can reliably identify meaningful variation in hospital performance; however, pediatric condition-specific readmission rates are limited by low patient volumes.

Objective: To determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals.

Design: Observational, retrospective cohort analysis.

Single-locus enrichment without amplification for sequencing and direct detection of epigenetic modifications.

A gene-level targeted enrichment method for direct detection of epigenetic modifications is described. The approach is demonstrated on the CGG-repeat region of the FMR1 gene, for which large repeat expansions, hitherto refractory to sequencing, are known to cause fragile X syndrome. In addition to achieving a single-locus enrichment of nearly 700,000-fold, the elimination of all amplification steps removes PCR-induced bias in the repeat count and preserves the native epigenetic modifications of the DNA.

Breast cancer survivors willingness to participate in an acupuncture clinical trial: a qualitative study.

Purpose: Acupuncture is a complementary and alternative medicine (CAM) modality that shows promise as a component of supportive breast cancer care. Lack of robust recruitment for clinical trial entry has limited the evidence base for acupuncture as a treatment modality among breast cancer survivors. The objective of this study is to identify key decision-making factors among breast cancer survivors considering entry into an acupuncture clinical trial for treatment of symptoms.

Interprofessional and Interdisciplinary Approach from Undergraduate Health and Pre-Medical Students in Children's Health Educational Initiative.

The importance of interprofessional training in healthcare to improve quality of care and health outcomes has been increasingly recognized. This pilot study used an interprofessional and interdisciplinary team of undergraduate health and pre-health students to establish a unique community partnership with a local elementary school in developing and implementing a nutrition/exercise educational intervention. Our results suggest that children as young as 8 years old are capable of learning new information related to the benefits of particular food groups, are capable of retaining this knowledge for 6 months, and that an intervention program as short as one hour every few months stand to make significant impact on children's knowledge about proper nutrition and healthy lifestyles.

Sleep disordered breathing with excessive daytime sleepiness is a risk factor for mortality in older adults.

Study Objectives: Excessive daytime sleepiness (EDS) is associated with increased mortality in older adults, yet sleep disordered breathing (SDB), a common cause of sleepiness, has not been shown to increase mortality in older adults. This study examined the relationship between daytime sleepiness, SDB, self-report sleep parameters, and mortality in older adults.

Design: Longitudinal cohort study.

Validating parameters of a luciferase reporter gene assay to measure neutralizing antibodies to IFNbeta in multiple sclerosis patients.

Neutralizing antibodies (NAbs) can occur in some multiple sclerosis (MS) patients receiving interferon beta (IFNbeta) therapy. NAbs reduce drug bioavailabity and high NAb titers reduce drug efficacy. We describe the validation of the R.