OHDSI MEETINGS THIS WEEK
NLP Work Group Meeting - Wednesday at 2pm EThttp://www.ohdsi.org/web/wiki/doku.php?id=projects:workgroups:nlp-wg
ANNOUNCEMENTS
Looking for presenters for our weekly OHDSI collaborator calls - If there are any topics you’d like to see discussed during an OHDSI community call, or you would like to present your work/research during a call, please email me at beaton@ohdsi.org to get on the agenda. Our weekly OHDSI calls take place every Tuesday at 12pm ET.
2016 Symposium Materials Online - Handouts and presentation slides and posters have been uploaded onto OHDSI.org . You can access them here: http://www.ohdsi.org/2016-ohdsi-symposium-materials/
Symposium Recordings - Recordings from the symposium are currently in post-production and will be uploaded shortly. A forum announcement and email will be sent to all registered participants when they have been made available.
COMMUNITY PUBLICATIONS
HW 04-3 GLOBAL NETWORK FOR HER-BASED BIG DATA ANALYSIS.https://www.ncbi.nlm.nih.gov/pubmed/27643279
HW 04-1 USEFULNESS OF BIG DATA IN CLINICAL RESEARCH.https://www.ncbi.nlm.nih.gov/pubmed/27643278
Drivers of maternity care in high-income countries: can health systems support woman-centred care?
D Shaw, JM Guise, N Shah, K Gemzell-Danielsson, KS Joseph, B Levy, F Wong, S Woodd and EK Main,
Lancet (London, England) , 2016 11 05
In high-income countries, medical interventions to address the known risks associated with pregnancy and birth have been largely successful and have resulted in very low levels of maternal and neonatal mortality. In this Series paper, we present the main care delivery models, with case studies of the USA and Sweden, and examine the main drivers of these models. Although nearly all births are attended by a skilled birth attendant and are in an institution, practice, cadre, facility size, and place of birth vary widely; for example, births occur in homes, birth centres, midwifery-led birthing units in hospitals, and in high intervention hospital birthing facilities. Not all care is evidenced-based, and some care provision may be harmful. Fear prevails among subsets of women and providers. In some settings, medical liability costs are enormous, human resource shortages are common, and costs of providing care can be very high. New challenges linked to alteration of epidemiology, such as obesity and older age during pregnancy, are also present. Data are often not readily available to inform policy and practice in a timely way and surveillance requires greater attention and investment. Outcomes are not equitable, and disadvantaged segments of the population face access issues and substantially elevated risks. At the same time, examples of excellence and progress exist, from clinical interventions to models of care and practice. Labourists (who provide care for all the facility's women for labour and delivery) are discussed as a potential solution. Quality and safety factors are informed by women's experiences, as well as medical evidence. Progress requires the ability to normalise birth for most women, with integrated services available if complications develop. We also discuss mechanisms to improve quality of care and highlight areas where research can address knowledge gaps with potential for impact. Evaluation of models that provide woman-centred care and the best outcomes without high costs is required to provide an impetus for change.
A Web API ecosystem through feature-based reuse
Participatory approach to the development of a knowledge base for problem-solving in diabetes self-management.
HJ Cole-Lewis, AM Smaldone, PR Davidson, R Kukafka, JN Tobin, A Cassells, ED Mynatt, G Hripcsak and L Mamykina,
International journal of medical informatics , Jan 2016
To develop an expandable knowledge base of reusable knowledge related to self-management of diabetes that can be used as a foundation for patient-centric decision support tools.The structure and components of the knowledge base were created in participatory design with academic diabetes educators using knowledge acquisition methods. The knowledge base was validated using scenario-based approach with practicing diabetes educators and individuals with diabetes recruited from Community Health Centers (CHCs) serving economically disadvantaged communities and ethnic minorities in New York.The knowledge base includes eight glycemic control problems, over 150 behaviors known to contribute to these problems coupled with contextual explanations, and over 200 specific action-oriented self-management goals for correcting problematic behaviors, with corresponding motivational messages. The validation of the knowledge base suggested high level of completeness and accuracy, and identified improvements in cultural appropriateness. These were addressed in new iterations of the knowledge base.The resulting knowledge base is theoretically grounded, incorporates practical and evidence-based knowledge used by diabetes educators in practice settings, and allows for personally meaningful choices by individuals with diabetes. Participatory design approach helped researchers to capture implicit knowledge of practicing diabetes educators and make it explicit and reusable.The knowledge base proposed here is an important step towards development of new generation patient-centric decision support tools for facilitating chronic disease self-management. While this knowledge base specifically targets diabetes, its overall structure and composition can be generalized to other chronic conditions.
Current Smoking Status Is Associated With Lower Quantitative CT Measures of Emphysema and Gas Trapping.
JA Zach, A Williams, SS Jou, K Yagihashi, D Everett, JE Hokanson, D Stinson and DA Lynch,
Journal of thoracic imaging , Jan 2016
The purposes of this study were to evaluate the effect of smoking status on quantitative computed tomography CT measures of low-attenuation areas (LAAs) on inspiratory and expiratory CT and to provide a method of adjusting for this effect.A total of 6762 current and former smokers underwent spirometry and volumetric inspiratory and expiratory CT. Quantitative CT analysis was completed using open-source 3D Slicer software. LAAs were defined as lung voxels with attenuation values ≤-950 Hounsfield units (HU) on inspiratory CT and ≤-856 HU on expiratory CT and were expressed as percentage of CT lung volume (%LAAI-950 and %LAAE-856). Multiple linear regression was used to determine the effect of smoking status on %LAAI-950 and %LAAE-856 while controlling for demographic variables, spirometric lung function, and smoking history, as well as total lung capacity (%LAAI-950) or functional residual capacity (%LAAE-856). Quantile normalization was used to align the %LAAI-950 distributions for current and former smokers.Mean %LAAI-950 was 4.2±7.1 in current smokers and 7.7±9.7 in former smokers (P<0.001). After adjusting for confounders, %LAAI-950 was 3.5 percentage points lower and %LAAE-856 was 6.0 percentage points lower in current smokers than in former smokers (P<0.001). After quantile normalization, smoking status was an insignificant variable in the inspiratory regression model, with %LAAI-950 being 0.27 percentage points higher in current smokers (P=0.13).After adjusting for patient demographics and lung function, current smokers display significantly lower %LAAI-950 and %LAAE-856 than do former smokers. Potential methods for adjusting for this effect would include adding a fixed value (eg, 3.5%) to the calculated percentage of emphysema in current smokers, or quantile normalization.
A time-indexed reference standard of adverse drug reactions.
R Harpaz, D Odgers, G Gaskin, W DuMouchel, R Winnenburg, O Bodenreider, A Ripple, A Szarfman, A Sorbello, E Horvitz, RW White and NH Shah,
Scientific data , 2014 11 11
Undetected adverse drug reactions (ADRs) pose a major burden on the health system. Data mining methodologies designed to identify signals of novel ADRs are of deep importance for drug safety surveillance. The development and evaluation of these methodologies requires proper reference benchmarks. While progress has recently been made in developing such benchmarks, our understanding of the performance characteristics of the data mining methodologies is limited because existing benchmarks do not support prospective performance evaluations. We address this shortcoming by providing a reference standard to support prospective performance evaluations. The reference standard was systematically curated from drug labeling revisions, such as new warnings, which were issued and communicated by the US Food and Drug Administration in 2013. The reference standard includes 62 positive test cases and 75 negative controls, and covers 44 drugs and 38 events. We provide usage guidance and empirical support for the reference standard by applying it to analyze two data sources commonly mined for drug safety surveillance.
