Background & Aims: With an increased emphasis on improving quality and decreasing costs, new tools are needed to improve adherence to evidence-based practices and guidelines in endoscopy. We investigated the ability of an automated system that uses natural language processing (NLP) and clinical decision support (CDS) to facilitate determination of colonoscopy surveillance intervals.
Methods: We performed a retrospective study at a single Veterans Administration medical center of patients age 40 years and older who had an index outpatient colonoscopy from 2002 through 2009 for any indication except surveillance of a previous colorectal neoplasia. We analyzed data from 10,798 reports, with 6379 linked to pathology results and 300 randomly selected reports. NLP-based CDS surveillance intervals were compared with those determined by paired, blinded, manual review. The primary outcome was adjusted agreement between manual review and the fully automated system.
Results: κ statistical analysis produced a value of 0.74 (P < .001) for agreement between the full text annotation and the NLP-based CDS system. Fifty-five reports (18.3%; 95% confidence interval, 14.1%-23.2%) differed between manual review and CDS recommendations. Of these, NLP error accounted for 30 (54.5%), incomplete resection of adenomatous tissue accounted for 14 (25.5%), and masses observed without biopsy findings of cancer accounted for 4 (7.2%). NLP-based CDS surveillance intervals had higher levels of agreement with the standard (81.7%) than the level agreement between experts (72% agreement between paired reviewers).
Conclusions: A fully automated system that uses NLP and a guideline-based CSD system can accurately facilitate guideline-recommended adherence surveillance for colonoscopy.
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http://dx.doi.org/10.1016/j.cgh.2013.11.025 | DOI Listing |
BMC Pharmacol Toxicol
January 2025
Medical Surgical Nursing, Department of Nursing, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Background: The global dissemination of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) poses a critical threat to public health. However, comprehensive data on the prevalence and resistance rates of CR-hvKp are limited. This systematic review and meta-analysis aim to estimate the pooled prevalence of carbapenem resistance among hvKp strains and assess the distribution of carbapenemase genes.
View Article and Find Full Text PDFBMC Health Serv Res
January 2025
Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal.
Background: The global elimination of leprosy transmission by 2030 is a World Health Organization (WHO) target. Nepal's leprosy elimination program depends on early case diagnosis and the performance of health workers and facilities. The knowledge and skills of paramedical staff (Leprosy Focal Person, LFP) and case documentation and management by health facilities are therefore key to the performance of health care services.
View Article and Find Full Text PDFJ Transl Med
January 2025
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Background: The evidence on the relationship of dietary antioxidant nutrients with the survival of ovarian cancer (OC) remains scarce.
Objective: This study aimed to investigate these associations in a prospective cohort of Chinese patients with OC.
Methods: In this prospective cohort study, patients with epithelial OC completed a food frequency questionnaire at diagnosis and 12 months post-diagnosis, and were followed from 2015 to 2023.
BMC Public Health
January 2025
Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse III, Toulouse, France.
Background: Sexual and reproductive health issues in adolescents living with HIV (ALHIV) have been left behind in HIV care programs. ALHIV are at risk of unintended pregnancy which jeopardizes their socio-economic future, health outcomes and exposes their newborn to HIV transmission. A better understanding of these events is needed.
View Article and Find Full Text PDFBMC Pediatr
January 2025
Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
Background: Infections may play a role in the etiology of sudden infant death syndrome (SIDS), with Bordetella pertussis being a potential agent. The objective was to analyze the association of SIDS and infant pertussis hospitalization rates over time, comparing a previously unvaccinated population (West Germany) versus a predominantly vaccinated population (East Germany).
Methods: We calculated SIDS rates per 1000 live births per state.
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