Improving Methods of Identifying Anaphylaxis for Medical Product Safety Surveillance Using Natural Language Processing and Machine Learning.

We sought to determine whether machine learning and natural language processing (NLP) applied to electronic medical records could improve performance of automated health-care claims-based algorithms to identify anaphylaxis events using data on 516 patients with outpatient, emergency department, or inpatient anaphylaxis diagnosis codes during 2015-2019 in 2 integrated health-care institutions in the Northwest United States. We used one site's manually reviewed gold-standard outcomes data for model development and the other's for external validation based on cross-validated area under the receiver operating characteristic curve (AUC), positive predictive value (PPV), and sensitivity. In the development site 154 (64%) of 239 potential events met adjudication criteria for anaphylaxis compared with 180 (65%) of 277 in the validation site.

Obstructive sleep apnea and risk of motor vehicle accident.

Objective: To evaluate the association between obstructive sleep apnea (OSA) and risk of motor vehicle accident (MVA).

Methods: We conducted a cohort study at Kaiser Permanente Washington using electronic health plan data and linked Washington State Department of Transportation MVA records. We included persons 18-79 years of age during 2005-2014.

Medication Related Self- efficacy among Linguistically Diverse Patients with Chronic Illnesses.

This study examines medication-related self-efficacy in a linguistically diverse group of patients with diabetes, hypertension, and elevated cholesterol. A telephone survey of 509 adults conducted in six languages (English, Spanish, Korean, Vietnamese, Mandarin, and Cantonese) was analyzed. Self-efficacy was assessed with the overall Medication Understanding and Use Self-Efficacy (MUSE) score and its two subscale scores on taking medication and learning about medications.

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients.

Background: Health systems are increasingly implementing remote telephone and Internet refill systems to enhance patient access to medication refills. Remote refill systems may provide an effective approach for improving medication non-adherence, but more research is needed among patients with limited English proficiency with poor access to remote refill systems.

Objective: To compare the use of remote medication refill systems among limited-English-proficiency (LEP) and English-proficient (EP) patients with chronic conditions.

Relationship between cardiovascular risk and lipid testing in one health care system: a retrospective cohort study.

Background: The US Preventive Services Taskforce (USPSTF) recommends routine lipid screening beginning age 35 for men [1]. For women age 20 and older, as well as men age 20-34, screening is recommended if cardiovascular risk factors are present. Prior research has focused on underutilization but not overuse of lipid testing.

Clinician identification of youth abusing over-the-counter products for weight control in a large U.S. integrated health system.

Background: Abuse of over-the-counter (OTC) products, such as diet pills and laxatives, for weight control by adolescents is well-documented and can precipitate serious medical conditions. Yet only a small percentage of youth with disordered weight control behaviors receive treatment. The objective of this study was to examine how often clinicians communicate with youth with symptoms consistent with abuse of OTC products for weight control about possible use of these products.