Development and validation of the Health Segment Classification of Population Encompassed within Singapore (HealthSCOPES) framework.

Introduction: The population is heterogeneous with varying levels of healthcare needs. Clustering individuals into health segments with more homogeneous healthcare needs allows for better understanding and monitoring of health profiles in the population, which can support data-driven resource allocation.

Methods: Using the developed criteria, data from several of Singapore's national administrative datasets were used to classify individuals into the various health segments.

The PROgnostic ModEl for chronic lung disease (PRO-MEL): development and temporal validation.

Background: Patients with chronic lung diseases (CLDs), defined as progressive and life-limiting respiratory conditions, experience a heavy symptom burden as the conditions become more advanced, but palliative referral rates are low and late. Prognostic tools can help clinicians identify CLD patients at high risk of deterioration for needs assessments and referral to palliative care. As current prognostic tools may not generalize well across all CLD conditions, we aim to develop and validate a general model to predict one-year mortality in patients presenting with any CLD.

Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review.

Objectives: There is a lack of prognostic information to guide the prediction of short-term all-cause mortality in patients with end-stage renal disease (ESRD). The aim was to review the risk factors that influenced the risk of short-term all-cause mortality in patients with ESRD.

Methods: MEDLINE, Embase, PubMed, CINAHL, the Cochrane Library and Web of Science databases were searched for articles published between 2000 and 2020.

Semi-automating abstract screening with a natural language model pretrained on biomedical literature.

We demonstrate the performance and workload impact of incorporating a natural language model, pretrained on citations of biomedical literature, on a workflow of abstract screening for studies on prognostic factors in end-stage lung disease. The model was optimized on one-third of the abstracts, and model performance on the remaining abstracts was reported. Performance of the model, in terms of sensitivity, precision, F1 and inter-rater agreement, was moderate in comparison with other published models.

Prognostic Factors of Mortality in Nonchronic Obstructive Pulmonary Disease Chronic Lung Disease: A Scoping Review.

Patients with chronic lung disease (CLD) experience a heavy symptom burden at the end of life, but their uptake of palliative care is notably low. Having an understanding of a patient's prognosis would facilitate shared decision making on treatment options and care planning between patients, families, and their clinicians, and complement clinicians' assessments of patients' unmet palliative needs. While literature on prognostication in patients with chronic obstructive pulmonary disease (COPD) has been established and summarized, information for other CLDs remains less consolidated.

Predicting mortality in patients diagnosed with advanced dementia presenting at an acute care hospital: the PROgnostic Model for Advanced DEmentia (PRO-MADE).

Background: Challenges in prognosticating patients diagnosed with advanced dementia (AD) hinders timely referrals to palliative care. We aim to develop and validate a prognostic model to predict one-year all-cause mortality (ACM) in patients with AD presenting at an acute care hospital.

Methods: This retrospective cohort study utilised administrative and clinical data from Tan Tock Seng Hospital (TTSH).

Understanding the role of fear of missing out and deficient self-regulation in sharing of deepfakes on social media: Evidence from eight countries.

Deepfakes are a troubling form of disinformation that has been drawing increasing attention. Yet, there remains a lack of psychological explanations for deepfake sharing behavior and an absence of research knowledge in non-Western contexts where public knowledge of deepfakes is limited. We conduct a cross-national survey study in eight countries to examine the role of fear of missing out (FOMO), deficient self-regulation (DSR), and cognitive ability in deepfake sharing behavior.

Emergency department interventions for frailty (EDIFY): improving functional outcomes in older persons at the emergency department through a multicomponent frailty intervention.

Objectives: emergency department interventions for frailty (EDIFY) delivers frailty-centric interventions at the emergency department (ED). We evaluated the effectiveness of a multicomponent frailty intervention (MFI) in improving functional outcomes among older persons.

Design: a quasi-experimental study.

Variation in coded frailty syndromes in secondary care administrative data: an international retrospective exploratory study.

Objectives: Challenges with manual methodologies to identify frailty, have led to enthusiasm for utilising large-scale administrative data, particularly standardised diagnostic codes. However, concerns have been raised regarding coding reliability and variability. We aimed to quantify variation in coding frailty syndromes within standardised diagnostic code fields of an international dataset.

Emergency Department Interventions for Frailty (EDIFY): Front-Door Geriatric Care Can Reduce Acute Admissions.

Objectives: The EDIFY program was developed to deliver early geriatric specialist interventions at the emergency department (ED) to reduce the number of acute admissions by identifying patients for safe discharge or transfer to low-acuity care settings. We evaluated the effectiveness of EDIFY in reducing potentially avoidable acute admissions.

Design: A quasi-experimental study.

Estimating Transmission Parameters for COVID-19 Clusters by Using Symptom Onset Data, Singapore, January-April 2020.

We estimated the generation interval distribution for coronavirus disease on the basis of serial intervals of observed infector-infectee pairs from established clusters in Singapore. The short mean generation interval and consequent high prevalence of presymptomatic transmission requires public health control measures to be responsive to these characteristics of the epidemic.

Automated Fastener vs Hand-tied Knots in Heart Valve Surgery: A Systematic Review and Meta-analysis.

Background: Although several studies revealed that the Cor-knot automated fastener (LSI Solutions, Victor, NY) reduces aortic cross-clamp and cardiopulmonary bypass times, the influence of the device on postoperative morbidity and mortality still needs to be evaluated. The aim of this study was to verify the hypothesis that the use of the Cor-knot device for heart valve surgery reduces aortic cross-clamp and cardiopulmonary bypass times, and this time saving translates into reduced morbidity and mortality.

Methods: Retrospective cohort studies and randomized controlled trials reporting on the use of the automated fastener vs hand-tied knots were reviewed.

Characterising and predicting persistent high-cost utilisers in healthcare: a retrospective cohort study in Singapore.

Objective: We aim to characterise persistent high utilisers (PHUs) of healthcare services, and correspondingly, transient high utilisers (THUs) and non-high utilisers (non-HUs) for comparison, to facilitate stratifying HUs for targeted intervention. Subsequently we apply machine learning algorithms to predict which HUs will persist as PHUs, to inform future trials testing the effectiveness of interventions in reducing healthcare utilisation in PHUs.

Design And Setting: This is a retrospective cohort study using administrative data from an Academic Medical Centre (AMC) in Singapore.

Right-Site Care Programme with a community-based family medicine clinic in Singapore: secondary data analysis of its impact on mortality and healthcare utilisation.

Objective: Stable patients with chronic conditions could be appropriately cared for at family medicine clinics (FMC) and discharged from hospital specialist outpatient clinics (SOCs). The Right-Site Care Programme with Frontier FMC emphasised care organised around patients in community rather than hospital-based providers, with one identifiable primary provider. This study evaluated impact of this programme on mortality and healthcare utilisation.

Stroke Factors Associated with Thrombolysis Use in Hospitals in Singapore and US: A Cross-Registry Comparative Study.

Background And Objectives: This paper aims to describe and compare the characteristics of 2 stroke populations in Singapore and in St. Louis, USA, and to document thrombolysis rates and contrast factors associated with its uptake in both populations.

Methods: The stroke populations described were from the Singapore Stroke Registry (SSR) in -Singapore and the Cognitive Rehabilitation Research Group Stroke Registry (CRRGSR) in St.

Computational Fluid Dynamics Modeling of Hemodynamic Parameters in the Human Diseased Aorta: A Systematic Review.

Background: The analysis of the correlation between blood flow and aortic pathology through computational fluid dynamics (CFD) shows promise in predicting disease progression, the effect of operative intervention, and guiding patient treatment. However, to date, there has not been a comprehensive systematic review of the published literature describing CFD in aortic diseases and their treatment.

Methods: This review includes 136 published articles which have investigated the application of CFD in all types of aortic disease (aneurysms, dissections, and coarctation).

Characterization of high healthcare utilizer groups using administrative data from an electronic medical record database.

Background: High utilizers (HUs) are a small group of patients who impose a disproportionately high burden on the healthcare system due to their elevated resource use. Identification of persistent HUs is pertinent as interventions have not been effective due to regression to the mean in majority of patients. This study will use cost and utilization metrics to segment a hospital-based patient population into HU groups.

Drivers of hospital expenditure and length of stay in an academic medical centre: a retrospective cross-sectional study.

Background: As healthcare expenditure and utilization continue to rise, understanding key drivers of hospital expenditure and utilization is crucial in policy development and service planning. This study aims to investigate micro drivers of hospital expenditure and length of stay (LOS) in an Academic Medical Centre.

Methods: Data corresponding to 285,767 patients and 207,426 inpatient visits was extracted from electronic medical records of the National University of Hospital in Singapore between 2005 to 2013.

Processing of Electronic Medical Records for Health Services Research in an Academic Medical Center: Methods and Validation.

Background: Electronic medical records (EMRs) contain a wealth of information that can support data-driven decision making in health care policy design and service planning. Although research using EMRs has become increasingly prevalent, challenges such as coding inconsistency, data validity, and lack of suitable measures in important domains still hinder the progress.

Objective: The objective of this study was to design a structured way to process records in administrative EMR systems for health services research and assess validity in selected areas.

Inclination towards research and the pursuit of a research career among medical students: an international cohort study.

Background: Involvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians' inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school.

Domain-Specific Adult Sedentary Behaviour Questionnaire (ASBQ) and the GPAQ Single-Item Question: A Reliability and Validity Study in an Asian Population.

This study examined the validity and reliability of a domain-specific Adult Sedentary Behaviour Questionnaire (ASBQ) and the Global Physical Activity Questionnaire (GPAQ) single-item sitting question using self- and interviewer-administered modes of administration against the triaxial ActiGraph wGT3X-BT accelerometer. The ASBQ and the GPAQ were administered twice, seven days apart. Participants were asked to put on the waist-worn accelerometer for seven days.

Role of Fat and Bone Biomarkers in the Relationship Between Ethnicity and Bone Mineral Density in Older Men.

Osteoporosis is an important health issue for older adults, and has been relatively understudied in older men. This study aimed to examine ethnic differences in bone mineral density (BMD), and elucidate the role of bone turnover markers (BTMs), fat and fat biomarkers on these ethnic differences. BMD at the lumbar spine and femoral neck, marrow fat at femoral neck, visceral adipose tissue (VAT) and subcutaneous adipose tissue, bone and fat biomarkers were evaluated in 120 healthy men aged ≥ 60 years.