Trustworthiness of a machine learning early warning model in medical and surgical inpatients.

Objectives: In the general hospital wards, machine learning (ML)-based early warning systems (EWSs) can identify patients at risk of deterioration to facilitate rescue interventions. We assess subpopulation performance of a ML-based EWS on medical and surgical adult patients admitted to general hospital wards.

Materials And Methods: We assessed the scores of an EWS integrated into the electronic health record and calculated every 15 minutes to predict a composite adverse event (AE): all-cause mortality, transfer to intensive care, cardiac arrest, or rapid response team evaluation.

Evaluation of parent reminder-recall letters to promote human papillomavirus vaccination.

Objective: Human papillomavirus (HPV) vaccine uptake remains suboptimal. Our stepped-wedge cluster randomized trial found that reminder-recall letters sent to parents of age-eligible children significantly increased vaccine uptake compared to usual care. Subsequently, we conducted a process evaluation to assess the mechanisms of the letter's effectiveness.

Implementation of Billing for Patient Portal Messages as E-Visits in a Large Integrated Health System.

Background: Patient-provider communication through the patient portal has markedly increased in recent years. Some health care facilities implemented programs to enable providers to bill for responding to patient-initiated messages that require substantive medical decision making through an e-visit.

Objective: To evaluate the effect of billing eligible patient-initiated portal messages as e-visits using a mixed-methods approach.

A virtual reality intervention to increase interracial empathy and upstander behaviors in nursing leaders.

Efforts to improve diversity, equity, and inclusion (DEI) in healthcare have increased, targeting healthcare worker biases with the goal of increasing inclusion of employees from racial and ethnic minoritized groups and improving care for patients from these groups. Virtual reality (VR) remains an underutilized mechanism for effecting behavior and attitude change. VR educational interventions work through two primary pathways, behavior rehearsal and embodiment.

Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction in the United States.

Background: The role of Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) is still unclear in patients with STEMI undergoing PCI in the current second-generation DES era.

Aims: This study aimed to evaluate the trends and outcomes of IVUS-guided PCI in patients with STEMI.

Methods: We used the National Inpatient Sample (NIS) database from 2016 to 2021.

Impact of smoking on the detection of brain aneurysms in general population screening: a systematic review and meta-analysis.

Objective: While the relationship between smoking and subarachnoid hemorrhage is well established, data regarding the probability of detecting unruptured intracranial aneurysms (UIAs) in smokers remain sparse. The aim of this systematic review and meta-analysis is to provide a comprehensive understanding of the relationship between smoking and the likelihood of identifying UIAs in healthy asymptomatic patients who underwent brain imaging for indications unrelated to UIAs.

Methods: A systematic review was conducted following the PRISMA guidelines.

Prognostic factors affecting ALS progression through disease tollgates.

Background And Objectives: Understanding factors affecting the timing of critical clinical events in ALS progression.

Methods: We captured ALS progression based on the timing of critical events (tollgates), by augmenting 6366 patients' data from the PRO-ACT database with tollgate-passed information using classification. Time trajectories of passing ALS tollgates after the first visit were derived using Kaplan-Meier analyses.

National Trends and Benchmarks for Operative Time and Hospital Length of Stay in Parotidectomies.

Objective: The extent of parotidectomy for benign tumors has de-escalated in the United States. We aim to define modern benchmarks for operative time and hospital length of stay (LOS) in parotidectomy and identify risk factors that may prolong these benchmarks.

Study Design: This is a retrospective cross-sectional study of all adults who underwent parotidectomy for a primary parotid neoplasm between January 2011 and December 2021 using the American College of Surgeons National Surgical Quality Improvement Program database.

Impact of Reach Height on Estimated Rotator Cuff Compression Risk in Manual Wheelchair Users With Spinal Cord Injury.

Reaching is a common daily activity requiring a range of humeral elevation that contributes to rotator cuff compression. The purpose of this study was to estimate supraspinatus and infraspinatus tendon compression risk relative to the acromion and coracoacromial ligament during reaching by manual wheelchair users with spinal cord injury. A cross-sectional design was used to evaluate 8 participants (7 males, median [range] age 36 y [23-61]).

Evaluating adoption and reach in a pragmatic randomized trial of community paramedicine for intermediate acuity patient care.

Introduction: Pragmatic trials aim to speed translation to practice by integrating study procedures in routine care settings. This study evaluated implementation outcomes related to clinician and patient recruitment and participation in a trial of community paramedicine (CP) and presents successes and challenges of maintaining pragmatic study features.

Methods: Adults in the pre-hospital setting, emergency department (ED), or hospital being considered for referral to the ED/hospital or continued hospitalization for intermediate-level care were randomized 1:1 to CP care or usual care.

Treatment trends of systemic lupus erythematosus from 2007 to 2023 in the USA.

Objective: To characterise the changing trends in the pharmacological management of SLE in the USA between 2007 and 2023 as new treatment options emerged.

Methods: In a retrospective cohort study using data from OptumLabs Data Warehouse, we characterised the annual prevalent (ie, all) and incident (ie, new) use of antimalarials, glucocorticoids and immunosuppressive medications among patients with SLE from 2007 to 2023 and assessed for changing trends over time.

Results: We identified 19 122 adults with SLE; they were 51.

Instruments evaluating the duration and pace of clinical encounters: A scoping review.

Objective: Hurried encounters in clinical settings contribute to dissatisfaction among both patients and clinicians and may indicate and contribute to low-quality care. We sought to identify patient- or clinician-reported instruments concerning this experience of time in clinical encounters.

Methods: We searched multiple databases from inception through July 2023.

American College of Surgeons Cancer Program Annual Report from 2021 Participant User File.

The National Cancer Database (NCDB) collects data from approximately 1,500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancers nationwide. The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in-depth report on treatment and outcomes in breast, pancreas, and colon cancers.

Using Centers for Medicare and Medicaid Services care compare data to create hospital-acquired infection count thresholds: a SAS program and analysis.

Using the Statistical Analysis System (SAS) program shared here, all US hospitals can calculate hospital-specific hospital-acquired infection threshold counts for achieving a pre-specified benchmarked Standardized Infection Ratio performance percentile.

Conservative Approach versus Percutaneous Coronary Intervention in Patients with Spontaneous Coronary Artery Dissection from a National Population-Based Cohort Study.

Background: Spontaneous coronary artery dissection (SCAD) is a rare and often underdiagnosed cause of acute coronary syndrome (ACS), predominantly affecting younger women without traditional cardiovascular risk factors. The management of SCAD remains a subject of debate, likely secondary to inconclusive evidence. This study aims to compare the clinical outcomes of SCAD patients treated with optimal medical therapy (OMT) versus those who underwent percutaneous coronary intervention (PCI) using a national population-based cohort.

American College of Surgeons survival calculator for biliary tract cancers: using machine learning to individualize predictions.

Background: Although cancer prognosis is most commonly estimated by tumor stage, survival is multifactorial. Our objective was to develop an American College of Surgeons "Biliary Tract Cancer Survival Calculator" prototype using machine learning to generate personalized survival estimates based on patient, tumor, and treatment factors.

Methods: The National Cancer Database was used to identify all patients with biliary tract malignancies between 2010 and 2017 including intrahepatic bile duct, extrahepatic bile duct, and gallbladder cancers.

Utility of the 2019 EULAR/ACR SLE classification criteria for predicting mortality and hospitalisation: development and cross-validation of ominosity score.

Objective: The 2019 European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) systemic lupus erythematosus (SLE) classification criteria score (≥20 points) has been associated with poor outcomes. We aimed to evaluate its utility as a predictor for mortality and hospitalisation and to derive and validate an ominosity score based on the SLE classification criteria set.

Methods: Incident patients with SLE in a population-based cohort were included.

The Global Prevalence of Iron Deficiency in Collegiate Athletes: A Systematic Review and Meta-Analysis.

Athletes are at high risk of iron deficiency even without anemia. In this systematic review and meta-analysis that included 17,519 athletes in 122 references from 23 countries, participating in 62 unique sports over a 41-year timeframe, approximately 53.9% of student-athletes were found to be hypoferritinemic (ferritin concentration below 50 mcg/L) with 23.