Defining the learning curve for robotic pancreaticoduodenectomy for a single surgeon following experience with laparoscopic pancreaticoduodenectomy.

Robotic pancreaticoduodenectomy (RPD) has a learning curve of approximately 30-250 cases to reach proficiency. The learning curve for laparoscopic pancreaticoduodenectomy (LPD) at Duke University was previously defined as 50 cases. This study describes the RPD learning curve for a single surgeon following experience with LPD.

Performance of Linear Mixed Models in Estimating Structural Rates of Glaucoma Progression Using Varied Random Effect Distributions.

Purpose: To compare how linear mixed models (LMMs) using Gaussian, Student , and log-gamma (LG) random effect distributions estimate rates of structural loss in a glaucomatous population using OCT and to compare model performance to ordinary least squares (OLS) regression.

Design: Retrospective cohort study.

Subjects: Patients in the Bascom Palmer Glaucoma Repository (BPGR).

mHealth Coping Skills Training for Symptom Management (mCOPE) for colorectal cancer patients in early to mid-adulthood: Study protocol for a randomized controlled trial.

Background: Colorectal cancer (CRC) patients in early to mid-adulthood (≤50 years) are challenged by high symptom burden (i.e., pain, fatigue, distress) and age-related stressors (e.

Intraocular Pressure and Rates of Macular Thinning in Glaucoma.

Purpose: To evaluate the effect of intraocular pressure (IOP) on the rates of macular thickness (ganglion cell layer [GCL] and ganglion cell-inner plexiform layer [GCIPL]) change over time measured by spectral-domain (SD) OCT.

Design: Retrospective cohort study.

Participants: Overall, 451 eyes of 256 patients with primary open-angle glaucoma.

Identifying Risk Factors for Blindness From Glaucoma at First Presentation to a Tertiary Clinic.

Purpose: Glaucoma is the leading cause of irreversible blindness, a crippling disability resulting in higher risks of chronic health conditions. To better understand disparities in blindness risk, we identified risk factors of blindness on first presentation to a glaucoma clinic using a large clinical database.

Design: Retrospective cross-sectional study.

Predictive Value of Early Autism Detection Models Based on Electronic Health Record Data Collected Before Age 1 Year.

Importance: Autism detection early in childhood is critical to ensure that autistic children and their families have access to early behavioral support. Early correlates of autism documented in electronic health records (EHRs) during routine care could allow passive, predictive model-based monitoring to improve the accuracy of early detection.

Objective: To quantify the predictive value of early autism detection models based on EHR data collected before age 1 year.

Rates of Glaucoma Progression Derived from Linear Mixed Models Using Varied Random Effect Distributions.

Purpose: To compare the ability of linear mixed models with different random effect distributions to estimate rates of visual field loss in glaucoma patients.

Methods: Eyes with five or more reliable standard automated perimetry (SAP) tests were identified from the Duke Glaucoma Registry. Mean deviation (MD) values from each visual field and associated timepoints were collected.

A Community Partnership to House and Care for Complex Patients with Unstable Housing.

Rising homelessness, especially among older adults, has significant ramifications for our health care system. People experiencing homelessness tend to experience worse health and poorer access to needed health care than people with stable housing. Commonwealth Care Alliance (CCA), a not-for-profit payer and provider that offers health plans to people dually eligible for Medicare and Medicaid, sought to address homelessness among its beneficiaries through a partnership with a local community-based housing organization, Hearth.

Rapid initial OCT RNFL thinning is predictive of faster visual field loss during extended follow-up in glaucoma.

Purpose: To investigate the relationship between the rate of retinal nerve fiber layer (RNFL) loss during initial follow-up and the magnitude of associated visual field loss during an extended follow-up period.

Design: Retrospective cohort study.

Methods: A total of 1,150 eyes of 839 glaucoma patients extracted from the Duke Glaucoma Registry.

Comparative effectiveness of oral anticoagulants in everyday practice.

Objectives: This study evaluated the comparative effectiveness of vitamin K antagonists (VKAs), direct thrombin inhibitors (DTIs) and factor Xa inhibitors (FXaI) in patients with atrial fibrillation (AF) at risk of stroke in everyday practice.

Methods: Data from patients with AF and Congestive heart failure, Hypertension, Age 75 years, Diabetes mellitus, prior Stroke, TIA, or thromboembolism, Vascular disease, Age 65-74 years, Sex category (CHADS-VASc) score ≥2 (excluding gender) in the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation registry were analysed using an improved method of propensity weighting, overlap weights and Cox proportional hazards models.

Results: All-cause mortality, non-haemorrhagic stroke/systemic embolism (SE) and major bleeding over 2 years were compared in 25 551 patients, 7162 (28.

An objective structural and functional reference standard in glaucoma.

The current lack of consensus for diagnosing glaucoma makes it difficult to develop diagnostic tests derived from deep learning (DL) algorithms. In the present study, we propose an objective definition of glaucomatous optic neuropathy (GON) using clearly defined parameters from optical coherence tomography and standard automated perimetry. We then use the proposed objective definition as reference standard to develop a DL algorithm to detect GON on fundus photos.

The Effect of Age on Increasing Susceptibility to Retinal Nerve Fiber Layer Loss in Glaucoma.

Purpose: To determine whether aging modifies the effect of intraocular pressure (IOP) on progressive glaucomatous retinal nerve fiber layer (RNFL) thinning over time.

Methods: This was a retrospective cohort study involving patients with glaucoma or suspected of having glaucoma who were followed over time from the Duke Glaucoma Registry. Rates of RNFL loss from spectral-domain optical coherence tomography (SD-OCT) were used to assess disease progression.

Health system utilization before age 1 among children later diagnosed with autism or ADHD.

Children with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) have 2-3 times increased healthcare utilization and annual costs once diagnosed, but little is known about their utilization patterns early in life. Quantifying their early health system utilization could uncover condition-specific health trajectories to facilitate earlier detection and intervention. Patients born 10/1/2006-10/1/2016 with ≥ 2 well-child visits within the Duke University Health System before age 1 were grouped as ASD, ADHD, ASD + ADHD, or No Diagnosis using retrospective billing codes.

Effect of Diabetes Control on Rates of Structural and Functional Loss in Patients with Glaucoma.

Purpose: To investigate the association between levels of diabetes mellitus (DM) control and rates of visual field and retinal nerve fiber layer (RNFL) loss over time in glaucoma.

Design: Retrospective cohort study.

Participants: A total of 351 eyes of 222 patients with type 2 DM with concomitant primary open-angle glaucoma (POAG) or suspected glaucoma extracted from the Duke Glaucoma Registry.

Artificial Intelligence Mapping of Structure to Function in Glaucoma.

Purpose: To develop an artificial intelligence (AI)-based structure-function (SF) map relating retinal nerve fiber layer (RNFL) damage on spectral domain optical coherence tomography (SDOCT) to functional loss on standard automated perimetry (SAP).

Methods: The study included 26,499 pairs of SAP and SDOCT from 15,173 eyes of 8878 patients with glaucoma or suspected of having the disease extracted from the Duke Glaucoma Registry. The data set was randomly divided at the patient level in training and test sets.

The Relationship Between Asymmetries of Corneal Properties and Rates of Visual Field Progression in Glaucoma Patients.

Unlabelled: PRéCIS:: In this study, asymmetries in corneal hysteresis (CH) between eyes of glaucoma patients were significantly associated with asymmetries in rates of visual field loss, suggesting a role of hysteresis as a risk factor for disease progression.

Purpose: The purpose of this study was to investigate the relationship between asymmetries in rates of glaucoma progression and asymmetries of corneal properties between eyes of subjects with primary open-angle glaucoma.

Participants And Methods: This prospective study followed 126 binocular subjects with glaucoma for an average of 4.

Comparing the Rule of 5 to Trend-based Analysis for Detecting Glaucoma Progression on OCT.

Purpose: The rule of 5 is a simple rule for detecting retinal nerve fiber layer (RNFL) change on spectral-domain OCT (SD-OCT), in which a loss of 5 μm of global RNFL on a follow-up test is considered evidence of significant change when compared with the baseline. The rule is based on short-term test-retest variability of SD-OCT and is often used in clinical practice. The purpose of this study was to compare the rule of 5 with trend-based analysis of global RNFL thickness over time for detecting glaucomatous progression.

Rationale and design of "Hearts & Parks": study protocol for a pragmatic randomized clinical trial of an integrated clinic-community intervention to treat pediatric obesity.

Background: The prevalence of child and adolescent obesity and severe obesity continues to increase despite decades of policy and research aimed at prevention. Obesity strongly predicts cardiovascular and metabolic disease risk; both begin in childhood. Children who receive intensive behavioral interventions can reduce body mass index (BMI) and reverse disease risk.

Impact of Intraocular Pressure Control on Rates of Retinal Nerve Fiber Layer Loss in a Large Clinical Population.

Purpose: To investigate the impact of intraocular pressure (IOP) control on rates of change of spectral-domain OCT (SD-OCT) retinal nerve fiber layer (RNFL) thickness in a large clinical population.

Design: Retrospective cohort study.

Participants: A total of 85 835 IOP measurements and 60 223 SD-OCT tests from 14 790 eyes of 7844 patients.

Rates of Glaucomatous Structural and Functional Change From a Large Clinical Population: The Duke Glaucoma Registry Study.

Purpose: To investigate rates of structural and functional change in a large clinical population of glaucoma and glaucoma suspect patients.

Design: Retrospective cohort.

Methods: Twenty-nine thousand five hundred forty-eight spectral-domain optical coherence tomography (OCT) and 19,812 standard automated perimetry (SAP) tests from 6138 eyes of 3669 patients with ≥6 months of follow-up, 2 good quality spectral-domain OCT peripapillary retinal nerve fiber layer scans, and 2 reliable SAP tests were included.

Assessment of a Segmentation-Free Deep Learning Algorithm for Diagnosing Glaucoma From Optical Coherence Tomography Scans.

Importance: Conventional segmentation of the retinal nerve fiber layer (RNFL) is prone to errors that may affect the accuracy of spectral-domain optical coherence tomography (SD-OCT) scans in detecting glaucomatous damage.

Objective: To develop a segmentation-free deep learning (DL) algorithm for assessment of glaucomatous damage using the entire circle B-scan image from SD-OCT.

Design, Setting, And Participants: This cross-sectional study at a single institution used data from SD-OCT images of eyes with glaucoma (perimetric and preperimetric) and normal eyes.

Quantification of Retinal Nerve Fibre Layer Thickness on Optical Coherence Tomography with a Deep Learning Segmentation-Free Approach.

This study describes a segmentation-free deep learning (DL) algorithm for measuring retinal nerve fibre layer (RNFL) thickness on spectral-domain optical coherence tomography (SDOCT). The study included 25,285 B-scans from 1,338 eyes of 706 subjects. Training was done to predict RNFL thickness from raw unsegmented scans using conventional RNFL thickness measurements from good quality images as targets, forcing the DL algorithm to learn its own representation of RNFL.