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Causal analysis for multivariate integrated clinical and environmental exposures data.
BMC Med Inform Decis Mak
January 2025
Renaissance Computing Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Electronic health records (EHRs) provide a rich source of observational patient data that can be explored to infer underlying causal relationships. These causal relationships can be applied to augment medical decision-making or suggest hypotheses for healthcare research. In this study, we explored a large-scale EHR dataset on patients with asthma or related conditions (N = 14,937).
View Article and Find Full Text PDFFHIR PIT: a geospatial and spatiotemporal data integration pipeline to support subject-level clinical research.
BMC Med Inform Decis Mak
January 2025
Renaissance Computing Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Background: Environmental exposures such as airborne pollutant exposures and socio-economic indicators are increasingly recognized as important to consider when conducting clinical research using electronic health record (EHR) data or other sources of clinical data such as survey data. While numerous public sources of geospatial and spatiotemporal data are available to support such research, the data are challenging to work with due to inconsistencies in file formats and spatiotemporal resolutions, computational challenges with large file sizes, and a lack of tools for patient- or subject-level data integration.
Results: We developed FHIR PIT (HL7® Fast Healthcare Interoperability Resources Patient data Integration Tool) as an open-source, modular, data-integration software pipeline that consumes EHR data in FHIR® format and integrates the data at the level of the patient or subject with environmental exposures data of varying spatiotemporal resolutions and file formats.
ADAPTing to participant distress: A protocol for applied improvisation in healthcare.
Med Educ
December 2024
School of Communication and Journalism, Stony Brook University, Stony Brook, New York, USA.
Introduction: Applied improvisation (improv) is an emerging innovative approach to clinical education and requires the cultivation of a highly engaged learning environment. With highly interactive and engaging forms of learning, it is critical to address participant distress and psychological safety in an improv learning environment in order to prevent damage to the learning capacities of individual participants as well as the group as a whole. However, little is available to guide applied improv practitioners to navigate the socially complex dynamics of participant distress during an improv session.
View Article and Find Full Text PDFEvaluating the value and risks of psychedelics for psychiatric medicine: a clinical perspective.
Expert Rev Neurother
December 2024
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
Introduction: After a long period of obscurantism, a possible role of psychedelics in clinical practice has progressively become a tangible perspective during the last two decades. However, the resounding enthusiasm linked to such 'psychedelic renaissance' runs the risk to unduly minimize the possible hazards associated with these compounds, while expanding their alleged benefits to improbable panacea-like proportions. In order to avoid mystifying or demonizing the properties of 5-HT2a agonists on emotional grounds, this subject requires a strictly unprejudiced and cautious approach to the evidence.
View Article and Find Full Text PDFPostoperative complications and cost implications in sickle cell disease patients undergoing total hip arthroplasty: A national inpatient sample study.
J Orthop
June 2025
Stony Brook University Hospital, Department of Orthopaedic Surgery, 100 Nicolls Rd, Stony Brook, NY, 11794, United States.
Background: Sickle cell disease (SCD) is a genetic condition affecting approximately 5 % of the global population, with significant prevalence in sub-Saharan Africa and an estimated 89,079 cases in the United States. Osteonecrosis, particularly of the femoral head (ONFH), is a common orthopaedic complication in SCD, often requiring total hip arthroplasty (THA) when conservative treatments fail. While THA can improve pain and function, it carries significant perioperative risks, with complication rates in patients with SCD as high as 67 %.
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