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1. Impact of a 'Chart Closure' Hard Stop Alert on Prescribing for Elevated Blood Pressures Among Patients With Diabetes: Quasi-Experimental Study

Author

Ramirez, Magaly, Chen, Kimberly, Follett, Robert W, Mangione, Carol M, Moreno, Gerardo, and Bell, Douglas S

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundUniversity of California at Los Angeles Health implemented a Best Practice Advisory (BPA) alert for the initiation of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) for individuals with diabetes. The BPA alert was configured with a “chart closure” hard stop, which demanded a response before closing the chart. ObjectiveThe aim of the study was to evaluate whether the implementation of the BPA was associated with changes in ACEI and ARB prescribing during primary care encounters for patients with diabetes. MethodsWe defined ACEI and ARB prescribing opportunities as primary care encounters in which the patient had a diabetes diagnosis, elevated blood pressure in recent encounters, no active ACEI or ARB prescription, and no contraindications. We used a multivariate logistic regression model to compare the change in the probability of an ACEI or ARB prescription during opportunity encounters before and after BPA implementation in primary care sites that did (n=30) and did not (n=31) implement the BPA. In an additional subgroup analysis, we compared ACEI and ARB prescribing in BPA implementation sites that had also implemented a pharmacist-led medication management program. ResultsWe identified a total of 2438 opportunity encounters across 61 primary care sites. The predicted probability of an ACEI or ARB prescription increased significantly from 11.46% to 22.17% during opportunity encounters in BPA implementation sites after BPA implementation. However, in the subgroup analysis, we only observed a significant improvement in ACEI and ARB prescribing in BPA implementation sites that had also implemented the pharmacist-led program. Overall, the change in the predicted probability of an ACEI or ARB prescription from before to after BPA implementation was significantly greater in BPA implementation sites compared with nonimplementation sites (difference-in-differences of 11.82; P

Published
2020
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2. Pharmacist-Led Diabetes Control Intervention and Health Outcomes in Hispanic Patients With Diabetes

Author

Narain, Kimberly Danae Cauley, Moreno, Gerardo, Bell, Douglas S, Chen, Lillian, Tseng, Chi-Hong, Follett, Robert W, Skootsky, Samuel, and Mangione, Carol M

Subjects
Health Services and Systems, Public Health, Health Sciences, Aging, Patient Safety, Clinical Research, Diabetes, Metabolic and endocrine, Good Health and Well Being, Female, Humans, Male, Middle Aged, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Hispanic or Latino, Outcome Assessment, Health Care, Pharmacists, Disease Management, Biomedical and clinical sciences, Health sciences
Abstract

ImportanceAmong patients with type 2 diabetes (T2D), Hispanic individuals are more likely than non-Hispanic White individuals to develop diabetes-related complications.ObjectiveTo examine the association of a pharmacist-led intervention (UCMyRx) with hemoglobin A1c (HbA1c) and systolic blood pressure (SBP) among Hispanic patients with T2D.Design, setting, and participantsThis quality improvement study used electronic health record data and a difference-in-differences study design to evaluate the association of UCMyRx exposure with changes in HbA1c concentration and SBP among Hispanic patients with T2D, relative to usual care, at University of California, Los Angeles primary care clinics between February and April of 2023. The study population included patients with an International Classification of Diseases, Ninth Revision/International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis of T2D, self-reporting Hispanic ethnicity, age 18 years or older, with 1 or more visits with a UCMyRx pharmacist (treatment) or 2 or more visits, 2 or more years apart, during the study window (comparison). Additionally, patients had to have the following observations during the study window (March 2, 2013-December 31, 2018): (1) a HbA1c 8% or higher, anywhere between 365 days before and 14 days after the index date (date of the first UCMyRx visit or a randomly generated index date) and a follow-up HbA1c measure within 120 to 365 days after the index date (n = 396) and/or (2) a SBP 140 mm Hg or higher between 365 days before and 14 days after the index date, and a follow-up SBP measure within 120 to 450 days after the index date (n = 795).ExposurePharmacists review laboratory results/vital signs, perform medication reconciliation, and develop personally tailored interventions to address adherence barriers and increase guideline-concordant care.Main outcomes and measuresPre- to post-index date changes in HbA1c and SBP.ResultsOf the 931 unique patients with T2D analyzed, the mean (SD) age was 64 (14.1) years, and 552 (59.3%) were female. In adjusted analyses, having 1 or more UCMyRx visits was associated with a reduction in HbA1c concentration (β = -0.46%; 95% CI, -0.84% to -0.07%) but no change in SBP (β = -1.71 mm Hg; 95% CI, -4.00 to 0.58 mm Hg).Conclusions and relevanceIn this quality improvement study of UCMyRx among Hispanic patients with T2D, a negative association was observed between UCMyRx exposure and HbA1c concentration but not SBP. Pharmacist-led intervention may be a strategy for improving outcomes among Hispanic patients with T2D.

Published
2023

3. Blockchain-enabled immutable, distributed, and highly available clinical research activity logging system for federated COVID-19 data analysis from multiple institutions

Author

Kuo, Tsung-Ting, Pham, Anh, Edelson, Maxim E, Kim, Jihoon, Chan, Jason, Gupta, Yash, Ohno-Machado, Lucila, Anderson, David M, Balacha, Chandrasekar, Bath, Tyler, Baxter, Sally L, Becker-Pennrich, Andrea, Bell, Douglas S, Bernstam, Elmer V, Ngan, Chau, Day, Michele E, Doctor, Jason N, DuVall, Scott, El-Kareh, Robert, Florian, Renato, Follett, Robert W, Geisler, Benjamin P, Ghigi, Alessandro, Gottlieb, Assaf, Hinske, Ludwig C, Hu, Zhaoxian, Ir, Diana, Jiang, Xiaoqian, Kim, Katherine K, Knight, Tara K, Koola, Jejo D, Lee, Nelson, Mansmann, Ulrich, Matheny, Michael E, Meeker, Daniella, Mou, Zongyang, Neumann, Larissa, Nguyen, Nghia H, Nick, Anderson, Park, Eunice, Paul, Paulina, Pletcher, Mark J, Post, Kai W, Rieder, Clemens, Scherer, Clemens, Schilling, Lisa M, Soares, Andrey, SooHoo, Spencer, Soysal, Ekin, Steven, Covington, Tep, Brian, Toy, Brian, Wang, Baocheng, Wu, Zhen R, Xu, Hua, Yong, Choi, Zheng, Kai, Zhou, Yujia, and Zucker, Rachel A

Subjects
Distributed Computing and Systems Software, Information and Computing Sciences, Emerging Infectious Diseases, Infectious Diseases, Coronaviruses, Humans, Blockchain, COVID-19, Research, electronic health record, blockchain distributed ledger technology, clinical information systems, decision support systems, R2D2 Consortium, Engineering, Medical and Health Sciences, Medical Informatics, Biomedical and clinical sciences, Health sciences, Information and computing sciences
Abstract

ObjectiveWe aimed to develop a distributed, immutable, and highly available cross-cloud blockchain system to facilitate federated data analysis activities among multiple institutions.Materials and methodsWe preprocessed 9166 COVID-19 Structured Query Language (SQL) code, summary statistics, and user activity logs, from the GitHub repository of the Reliable Response Data Discovery for COVID-19 (R2D2) Consortium. The repository collected local summary statistics from participating institutions and aggregated the global result to a COVID-19-related clinical query, previously posted by clinicians on a website. We developed both on-chain and off-chain components to store/query these activity logs and their associated queries/results on a blockchain for immutability, transparency, and high availability of research communication. We measured run-time efficiency of contract deployment, network transactions, and confirmed the accuracy of recorded logs compared to a centralized baseline solution.ResultsThe smart contract deployment took 4.5 s on an average. The time to record an activity log on blockchain was slightly over 2 s, versus 5-9 s for baseline. For querying, each query took on an average less than 0.4 s on blockchain, versus around 2.1 s for baseline.DiscussionThe low deployment, recording, and querying times confirm the feasibility of our cross-cloud, blockchain-based federated data analysis system. We have yet to evaluate the system on a larger network with multiple nodes per cloud, to consider how to accommodate a surge in activities, and to investigate methods to lower querying time as the blockchain grows.ConclusionBlockchain technology can be used to support federated data analysis among multiple institutions.

Published
2023

4. Association of Antiosteoporotic Medication Bisphosphonates and Denosumab with Primary Breast Cancer: An Electronic Health Record Cohort Study

Author

Stanoyevitch, Alexander, Zhang, Lei, Sanz, Javier, Follett, Robert W, and Bell, Douglas S

Subjects
Health Services and Systems, Health Sciences, Aging, Breast Cancer, Prevention, Cancer, Clinical Research, bisphosphonates, breast cancer, denosumab, osteoporosis, statins, Public health
Abstract

Background: The risks of osteoporosis and breast cancer are increasing in elderly women. Bisphosphonates and denosumab are recommended for treatment of osteoporosis. They have different and overlapping pharmacodynamics and previous studies have shown conflicting results regarding their risk association with breast cancer. We intend to further look into this issue through a comparative study. Methods: Electronic health records of 91,626 women older than 50 years with no previous history of malignancy and no nonbreast cancer during follow-up were retrieved from southern California and retrospectively analyzed using univariate, bivariate, and log-rank tests. Medication use, breast cancer risk, and associated demographic and clinical history were assessed. Results: Over an average of 3.6 years follow-up, the breast cancer relative risks (RRs) counted after 365 days of latency are 1.12 (95% confidence interval [CI]: 0.64-1.97) for denosumab ever users and 0.37 (95% CI: 0.21-0.66) for bisphosphonates ever users, when covariates are comparable. The significant difference is supported by the Log-rank test (p = 0.0004). Excluding statins coprescribers, the breast cancer RR is 1.31 (0.71, 2.43) in denosumab group and 0.26 (0.11, 0.62) in bisphosphonates group. There is a reduced RR in statins ever users (0.47, 95% CI: 0.38-0.58), and the breast cancer risk difference is not significant between concomitant denosumab/statins and bisphosphonates/statins ever users with RR 0.65 (0.16, 2.58) versus 0.55 (0.26, 1.16), p = 0.692. Conclusions: Our data support an association of lower breast cancer risk with bisphosphonates use in elderly women. We did not observe a lower breast cancer risk in denosumab group; however, our data revealed a potential lower breast cancer risk in denosumab users with concurrent statins use and this requires further study.

Published
2021

5. Privacy-protecting, reliable response data discovery using COVID-19 patient observations

Author

Kim, Jihoon, Neumann, Larissa, Paul, Paulina, Day, Michele E, Aratow, Michael, Bell, Douglas S, Doctor, Jason N, Hinske, Ludwig C, Jiang, Xiaoqian, Kim, Katherine K, Matheny, Michael E, Meeker, Daniella, Pletcher, Mark J, Schilling, Lisa M, SooHoo, Spencer, Xu, Hua, Zheng, Kai, Ohno-Machado, Lucila, Anderson, David M, Anderson, Nicholas R, Balacha, Chandrasekar, Bath, Tyler, Baxter, Sally L, Becker-Pennrich, Andrea, Bernstam, Elmer V, Carter, William A, Chau, Ngan, Choi, Yong, Covington, Steven, DuVall, Scott, El-Kareh, Robert, Florian, Renato, Follett, Robert W, Geisler, Benjamin P, Ghigi, Alessandro, Gottlieb, Assaf, Hu, Zhaoxian, Ir, Diana, Knight, Tara K, Koola, Jejo D, Kuo, Tsung-Ting, Lee, Nelson, Mansmann, Ulrich, Mou, Zongyang, Murphy, Robert E, Nguyen, Nghia H, Niedermayer, Sebastian, Park, Eunice, Perkins, Amy M, Post, Kai W, Rieder, Clemens, Scherer, Clemens, Soares, Andrey, Soysal, Ekin, Tep, Brian, Toy, Brian, Wang, Baocheng, Wu, Zhen R, Zhou, Yujia, and Zucker, Rachel A

Subjects
Information and Computing Sciences, Health Services and Systems, Health Sciences, Infectious Diseases, Emerging Infectious Diseases, Coronaviruses, Generic health relevance, Good Health and Well Being, Algorithms, COVID-19, Common Data Elements, Computer Communication Networks, Confidentiality, Electronic Health Records, Female, Humans, Information Storage and Retrieval, Logistic Models, Male, Natural Language Processing, Registries, observational study, common data elements, electronic health record, regression analysis, R2D2 Consortium, Engineering, Medical and Health Sciences, Medical Informatics, Biomedical and clinical sciences, Health sciences, Information and computing sciences
Abstract

ObjectiveTo utilize, in an individual and institutional privacy-preserving manner, electronic health record (EHR) data from 202 hospitals by analyzing answers to COVID-19-related questions and posting these answers online.Materials and methodsWe developed a distributed, federated network of 12 health systems that harmonized their EHRs and submitted aggregate answers to consortia questions posted at https://www.covid19questions.org. Our consortium developed processes and implemented distributed algorithms to produce answers to a variety of questions. We were able to generate counts, descriptive statistics, and build a multivariate, iterative regression model without centralizing individual-level data.ResultsOur public website contains answers to various clinical questions, a web form for users to ask questions in natural language, and a list of items that are currently pending responses. The results show, for example, that patients who were taking angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, within the year before admission, had lower unadjusted in-hospital mortality rates. We also showed that, when adjusted for, age, sex, and ethnicity were not significantly associated with mortality. We demonstrated that it is possible to answer questions about COVID-19 using EHR data from systems that have different policies and must follow various regulations, without moving data out of their health systems.Discussion and conclusionsWe present an alternative or a complement to centralized COVID-19 registries of EHR data. We can use multivariate distributed logistic regression on observations recorded in the process of care to generate results without transferring individual-level data outside the health systems.

Published
2021

6. Validation of an internationally derived patient severity phenotype to support COVID-19 analytics from electronic health record data

Author

Klann, Jeffrey G, Estiri, Hossein, Weber, Griffin M, Moal, Bertrand, Avillach, Paul, Hong, Chuan, Tan, Amelia LM, Beaulieu-Jones, Brett K, Castro, Victor, Maulhardt, Thomas, Geva, Alon, Malovini, Alberto, South, Andrew M, Visweswaran, Shyam, Morris, Michele, Samayamuthu, Malarkodi J, Omenn, Gilbert S, Ngiam, Kee Yuan, Mandl, Kenneth D, Boeker, Martin, Olson, Karen L, Mowery, Danielle L, Follett, Robert W, Hanauer, David A, Bellazzi, Riccardo, Moore, Jason H, Loh, Ne-Hooi Will, Bell, Douglas S, Wagholikar, Kavishwar B, Chiovato, Luca, Tibollo, Valentina, Rieg, Siegbert, Li, Anthony LLJ, Jouhet, Vianney, Schriver, Emily, Xia, Zongqi, Hutch, Meghan, Luo, Yuan, Kohane, Isaac S, EHR, The Consortium for Clinical Characterization of COVID-19 by, Brat, Gabriel A, and Murphy, Shawn N

Subjects
Health Services and Systems, Health Sciences, Patient Safety, HIV/AIDS, Good Health and Well Being, COVID-19, Electronic Health Records, Hospitalization, Humans, Machine Learning, Prognosis, ROC Curve, Sensitivity and Specificity, Severity of Illness Index, novel coronavirus, disease severity, computable phenotype, medical informatics, data networking, data interoperability, Consortium for Clinical Characterization of COVID-19 by EHR (4CE), Information and Computing Sciences, Engineering, Medical and Health Sciences, Medical Informatics, Biomedical and clinical sciences, Health sciences, Information and computing sciences
Abstract

ObjectiveThe Consortium for Clinical Characterization of COVID-19 by EHR (4CE) is an international collaboration addressing coronavirus disease 2019 (COVID-19) with federated analyses of electronic health record (EHR) data. We sought to develop and validate a computable phenotype for COVID-19 severity.Materials and methodsTwelve 4CE sites participated. First, we developed an EHR-based severity phenotype consisting of 6 code classes, and we validated it on patient hospitalization data from the 12 4CE clinical sites against the outcomes of intensive care unit (ICU) admission and/or death. We also piloted an alternative machine learning approach and compared selected predictors of severity with the 4CE phenotype at 1 site.ResultsThe full 4CE severity phenotype had pooled sensitivity of 0.73 and specificity 0.83 for the combined outcome of ICU admission and/or death. The sensitivity of individual code categories for acuity had high variability-up to 0.65 across sites. At one pilot site, the expert-derived phenotype had mean area under the curve of 0.903 (95% confidence interval, 0.886-0.921), compared with an area under the curve of 0.956 (95% confidence interval, 0.952-0.959) for the machine learning approach. Billing codes were poor proxies of ICU admission, with as low as 49% precision and recall compared with chart review.DiscussionWe developed a severity phenotype using 6 code classes that proved resilient to coding variability across international institutions. In contrast, machine learning approaches may overfit hospital-specific orders. Manual chart review revealed discrepancies even in the gold-standard outcomes, possibly owing to heterogeneous pandemic conditions.ConclusionsWe developed an EHR-based severity phenotype for COVID-19 in hospitalized patients and validated it at 12 international sites.

Published
2021

7. Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium

Author

Aaron, James R., Adam, Atif, Agapito, Giuseppe, Albayrak, Adem, Albi, Giuseppe, Alessiani, Mario, Alloni, Anna, Amendola, Danilo F., Angoulvant, François, Anthony, Li LLJ., Aronow, Bruce J., Ashraf, Fatima, Atz, Andrew, Avillach, Paul, Panickan, Vidul Ayakulangara, Azevedo, Paula S., Badenes, Rafael, Balshi, James, Batugo, Ashley, Beaulieu-Jones, Brendin R., Beaulieu-Jones, Brett K., Bell, Douglas S., Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal-Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Bhatnagar, Surbhi, Blanco-Martínez, Alvar, Boeker, Martin, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence T., Bradford, Robert L., Brat, Gabriel A., Bréant, Stéphane, Brown, Nicholas W., Bruno, Raffaele, Bryant, William A., Bucalo, Mauro, Bucholz, Emily, Burgun, Anita, Cai, Tianxi, Cannataro, Mario, Carmona, Aldo, Cattelan, Anna Maria, Caucheteux, Charlotte, Champ, Julien, Chen, Jin, Chen, Krista Y., Chiovato, Luca, Chiudinelli, Lorenzo, Cho, Kelly, Cimino, James J., Colicchio, Tiago K., Cormont, Sylvie, Cossin, Sébastien, Craig, Jean B., Cruz-Bermúdez, Juan Luis, Cruz-Rojo, Jaime, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Das, Priyam, Devkota, Batsal, Dionne, Audrey, Duan, Rui, Dubiel, Julien, DuVall, Scott L., Esteve, Loic, Estiri, Hossein, Fan, Shirley, Follett, Robert W., Ganslandt, Thomas, García-Barrio, Noelia, Garmire, Lana X., Gehlenborg, Nils, Getzen, Emily J., Geva, Alon, Goh, Rachel SJ., González, Tomás González, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Gutiérrez-Sacristán, Alba, Guzzi, Pietro H., Han, Larry, Hanauer, David A., Haverkamp, Christian, Hazard, Derek Y., He, Bing, Henderson, Darren W., Hilka, Martin, Ho, Yuk-Lam, Holmes, John H., Honerlaw, Jacqueline P., Hong, Chuan, Huling, Kenneth M., Hutch, Meghan R., Issitt, Richard W., Jannot, Anne Sophie, Jouhet, Vianney, Kainth, Mundeep K., Kate, Kernan F., Kavuluru, Ramakanth, Keller, Mark S., Kennedy, Chris J., Kernan, Kate F., Key, Daniel A., Kirchoff, Katie, Klann, Jeffrey G., Kohane, Isaac S., Krantz, Ian D., Kraska, Detlef, Krishnamurthy, Ashok K., L'Yi, Sehi, Leblanc, Judith, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, Will Loh, Ne Hooi, Long, Qi, Lozano-Zahonero, Sara, Luo, Yuan, Lynch, Kristine E., Mahmood, Sadiqa, Maidlow, Sarah E., Makoudjou, Adeline, Makwana, Simran, Malovini, Alberto, Mandl, Kenneth D., Mao, Chengsheng, Maram, Anupama, Maripuri, Monika, Martel, Patricia, Martins, Marcelo R., Marwaha, Jayson S., Masino, Aaron J., Mazzitelli, Maria, Mazzotti, Diego R., Mensch, Arthur, Milano, Marianna, Minicucci, Marcos F., Moal, Bertrand, Ahooyi, Taha Mohseni, Moore, Jason H., Moraleda, Cinta, Morris, Jeffrey S., Morris, Michele, Moshal, Karyn L., Mousavi, Sajad, Mowery, Danielle L., Murad, Douglas A., Murphy, Shawn N., Naughton, Thomas P., Breda Neto, Carlos Tadeu, Neuraz, Antoine, Newburger, Jane, Ngiam, Kee Yuan, Njoroge, Wanjiku FM., Norman, James B., Obeid, Jihad, Okoshi, Marina P., Olson, Karen L., Omenn, Gilbert S., Orlova, Nina, Ostasiewski, Brian D., Palmer, Nathan P., Paris, Nicolas, Patel, Lav P., Pedrera-Jiménez, Miguel, Pfaff, Ashley C., Pfaff, Emily R., Pillion, Danielle, Pizzimenti, Sara, Priya, Tanu, Prokosch, Hans U., Prudente, Robson A., Prunotto, Andrea, Quirós-González, Víctor, Ramoni, Rachel B., Raskin, Maryna, Rieg, Siegbert, Roig-Domínguez, Gustavo, Rojo, Pablo, Romero-Garcia, Nekane, Rubio-Mayo, Paula, Sacchi, Paolo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi Jebathilagam, Sanchez-Pinto, L. Nelson, Sandrin, Arnaud, Santhanam, Nandhini, Santos, Janaina C.C., Sanz Vidorreta, Fernando J., Savino, Maria, Schriver, Emily R., Schubert, Petra, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil J., Serrano-Balazote, Pablo, Serre, Patricia, Serret-Larmande, Arnaud, Shah, Mohsin A., Hossein Abad, Zahra Shakeri, Silvio, Domenick, Sliz, Piotr, Son, Jiyeon, Sonday, Charles, South, Andrew M., Sperotto, Francesca, Spiridou, Anastasia, Strasser, Zachary H., Tan, Amelia LM., Tan, Bryce W.Q., Tan, Byorn W.L., Tanni, Suzana E., Taylor, Deanne M., Terriza-Torres, Ana I., Tibollo, Valentina, Tippmann, Patric, Toh, Emma MS., Torti, Carlo, Trecarichi, Enrico M., Vallejos, Andrew K., Varoquaux, Gael, Vella, Margaret E., Verdy, Guillaume, Vie, Jill-Jênn, Visweswaran, Shyam, Vitacca, Michele, Wagholikar, Kavishwar B., Waitman, Lemuel R., Wang, Xuan, Wassermann, Demian, Weber, Griffin M., Wolkewitz, Martin, Wong, Scott, Xia, Zongqi, Xiong, Xin, Ye, Ye, Yehya, Nadir, Yuan, William, Zachariasse, Joany M., Zahner, Janet J., Zambelli, Alberto, Zhang, Harrison G., Zöller, Daniela, Zuccaro, Valentina, Zucco, Chiara, Li, Xiudi, Rofeberg, Valerie N., Elias, Matthew D., Laird-Gion, Jessica, and Newburger, Jane W.

Published
2023
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8. Characterization of long COVID temporal sub-phenotypes by distributed representation learning from electronic health record data: a cohort study

Author

Aaron, James R., Agapito, Giuseppe, Albayrak, Adem, Albi, Giuseppe, Alessiani, Mario, Alloni, Anna, Amendola, Danilo F., François Angoulvant, Anthony, Li L.L.J., Aronow, Bruce J., Ashraf, Fatima, Atz, Andrew, Avillach, Paul, Azevedo, Paula S., Balshi, James, Beaulieu-Jones, Brett K., Bell, Douglas S., Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal-Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Bhatnagar, Surbhi, Blanco-Martínez, Alvar, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence T., Bradford, Robert L., Brat, Gabriel A., Bréant, Stéphane, Brown, Nicholas W., Bruno, Raffaele, Bryant, William A., Bucalo, Mauro, Bucholz, Emily, Burgun, Anita, Cai, Tianxi, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Jin, Chen, Krista Y., Chiovato, Luca, Chiudinelli, Lorenzo, Cho, Kelly, Cimino, James J., Colicchio, Tiago K., Cormont, Sylvie, Cossin, Sébastien, Craig, Jean B., Cruz-Bermúdez, Juan Luis, Cruz-Rojo, Jaime, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Das, Priyam, Devkota, Batsal, Dionne, Audrey, Duan, Rui, Dubiel, Julien, DuVall, Scott L., Esteve, Loic, Estiri, Hossein, Fan, Shirley, Follett, Robert W., Ganslandt, Thomas, Barrio, Noelia García, Garmire, Lana X., Gehlenborg, Nils, Getzen, Emily J., Geva, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Gutiérrez-Sacristán, Alba, Han, Larry, Hanauer, David A., Haverkamp, Christian, Hazard, Derek Y., He, Bing, Henderson, Darren W., Hilka, Martin, Ho, Yuk-Lam, Holmes, John H., Hong, Chuan, Huling, Kenneth M., Hutch, Meghan R., Issitt, Richard W., Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Keller, Mark S., Kennedy, Chris J., Key, Daniel A., Kirchoff, Katie, Klann, Jeffrey G., Kohane, Isaac S., Krantz, Ian D., Kraska, Detlef, Krishnamurthy, Ashok K., L'Yi, Sehi, Le, Trang T., Leblanc, Judith, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, Will Loh, Ne Hooi, Long, Qi, Lozano-Zahonero, Sara, Luo, Yuan, Lynch, Kristine E., Mahmood, Sadiqa, Maidlow, Sarah E., Makoudjou, Adeline, Malovini, Alberto, Mandl, Kenneth D., Mao, Chengsheng, Maram, Anupama, Martel, Patricia, Martins, Marcelo R., Marwaha, Jayson S., Masino, Aaron J., Mazzitelli, Maria, Mensch, Arthur, Milano, Marianna, Minicucci, Marcos F., Moal, Bertrand, Ahooyi, Taha Mohseni, Moore, Jason H., Moraleda, Cinta, Morris, Jeffrey S., Morris, Michele, Moshal, Karyn L., Mousavi, Sajad, Mowery, Danielle L., Murad, Douglas A., Murphy, Shawn N., Naughton, Thomas P., Breda Neto, Carlos Tadeu, Neuraz, Antoine, Newburger, Jane, Ngiam, Kee Yuan, Njoroge, Wanjiku F.M., Norman, James B., Obeid, Jihad, Okoshi, Marina P., Olson, Karen L., Omenn, Gilbert S., Orlova, Nina, Ostasiewski, Brian D., Palmer, Nathan P., Paris, Nicolas, Patel, Lav P., Pedrera-Jiménez, Miguel, Pfaff, Emily R., Pfaff, Ashley C., Pillion, Danielle, Pizzimenti, Sara, Prokosch, Hans U., Prudente, Robson A., Prunotto, Andrea, Quirós-González, Víctor, Ramoni, Rachel B., Raskin, Maryna, Rieg, Siegbert, Roig-Domínguez, Gustavo, Rojo, Pablo, Rubio-Mayo, Paula, Sacchi, Paolo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi Jebathilagam, Sanchez-Pinto, L. Nelson, Sandrin, Arnaud, Santhanam, Nandhini, Santos, Janaina C.C., Sanz Vidorreta, Fernando J., Savino, Maria, Schriver, Emily R., Schubert, Petra, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil J., Serrano-Balazote, Pablo, Serre, Patricia, Serret-Larmande, Arnaud, Shah, Mohsin, Hossein Abad, Zahra Shakeri, Silvio, Domenick, Sliz, Piotr, Son, Jiyeon, Sonday, Charles, South, Andrew M., Spiridou, Anastasia, Strasser, Zachary H., Tan, Amelia L.M., Tan, Bryce W.Q., Tan, Byorn W.L., Tanni, Suzana E., Taylor, Deanne M., Terriza-Torres, Ana I., Tibollo, Valentina, Tippmann, Patric, Toh, Emma M.S., Torti, Carlo, Trecarichi, Enrico M., Tseng, Yi-Ju, Vallejos, Andrew K., Varoquaux, Gael, Vella, Margaret E., Verdy, Guillaume, Vie, Jill-Jênn, Visweswaran, Shyam, Vitacca, Michele, Wagholikar, Kavishwar B., Waitman, Lemuel R., Wang, Xuan, Wassermann, Demian, Weber, Griffin M., Wolkewitz, Martin, Wong, Scott, Xia, Zongqi, Xiong, Xin, Ye, Ye, Yehya, Nadir, Yuan, William, Zambelli, Alberto, Zhang, Harrison G., Zo¨ller, Daniela, Zuccaro, Valentina, Zucco, Chiara, Mesa, Rebecca, and Verdy, Guillame

Published
2023
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9. An Effectiveness Evaluation of a Primary Care–Embedded Clinical Pharmacist–Led Intervention Among Blacks with Diabetes

Author

Narain, Kimberly Danae Cauley, Doppee, Danielle, Li, Ning, Moreno, Gerardo, Bell, Douglas S, Do, Amanda L, Follett, Robert W, and Mangione, Carol M

Subjects
Health Services and Systems, Public Health, Health Sciences, Diabetes, Patient Safety, Prevention, Clinical Research, Health Services, 7.1 Individual care needs, Management of diseases and conditions, Metabolic and endocrine, Good Health and Well Being, Black or African American, Diabetes Mellitus, Type 2, Humans, Medication Adherence, Pharmacists, Primary Health Care, diabetes, "racial disparities", pharmacist, "medication adherence", "quality of care", intervention, “medication adherence”, “quality of care”, “racial disparities”, Clinical Sciences, General & Internal Medicine, Clinical sciences, Health services and systems, Public health
Abstract

BackgroundBlack individuals with type 2 diabetes suffer disproportionate morbidity and mortality relative to whites with type 2 diabetes, irrespective of health insurance coverage.ObjectiveExamine the impact of a primary care-embedded clinical pharmacist-led intervention (UCMyRx) on cardiovascular risk factor control among blacks with type 2 diabetes in a large healthcare system.DesignWe used data extracted from the electronic health records (EHR) system and a difference-in-differences study design with a propensity-matched comparison group to evaluate the impact of UCMyRx on HbA1c and systolic blood pressure (SBP) among black patients with type 2 diabetes, relative to usual care.ParticipantsIndividuals with type 2 diabetes identified as either black or African American in the EHR that were ≥ 18 years of age that had the following observations during the study window (03/02/2013-12/31/18: (1) HbA1C ≥ 8%, at least once, anywhere between 365 days before and 14 days after the UCMyRx visit and a follow-up HbA1c measure within 120 to 365 days after the visit and/or (2) SBP ≥ 140 mmHg at least once between 365 days before and 14 days after the UCMyRx visit that had a follow-up SBP measure within 120 to 450 days after the visit.InterventionUCMyRx pharmacists review labs and vital signs, perform medication reconciliation, use a standardized survey to assess barriers to medication adherence, and develop tailored interventions to improve medication adherence.Main measuresChange in HbA1c and change in SBP from before to after the first UCMyRx visit.Key resultsHaving at least one visit with a UCMyRx clinical pharmacist was associated with a significant reduction in HbA1c (- 0.4%, p value = .01); however, there was no significant impact on SBP (- .051 mmHg, p value = 0.74).ConclusionsThe UCMyRx intervention is a useful strategy for improving HbA1c control among blacks with type 2 diabetes.

Published
2020

10. International electronic health record-derived COVID-19 clinical course profiles: the 4CE consortium

Author

Brat, Gabriel A, Weber, Griffin M, Gehlenborg, Nils, Avillach, Paul, Palmer, Nathan P, Chiovato, Luca, Cimino, James, Waitman, Lemuel R, Omenn, Gilbert S, Malovini, Alberto, Moore, Jason H, Beaulieu-Jones, Brett K, Tibollo, Valentina, Murphy, Shawn N, Yi, Sehi L’, Keller, Mark S, Bellazzi, Riccardo, Hanauer, David A, Serret-Larmande, Arnaud, Gutierrez-Sacristan, Alba, Holmes, John J, Bell, Douglas S, Mandl, Kenneth D, Follett, Robert W, Klann, Jeffrey G, Murad, Douglas A, Scudeller, Luigia, Bucalo, Mauro, Kirchoff, Katie, Craig, Jean, Obeid, Jihad, Jouhet, Vianney, Griffier, Romain, Cossin, Sebastien, Moal, Bertrand, Patel, Lav P, Bellasi, Antonio, Prokosch, Hans U, Kraska, Detlef, Sliz, Piotr, Tan, Amelia LM, Ngiam, Kee Yuan, Zambelli, Alberto, Mowery, Danielle L, Schiver, Emily, Devkota, Batsal, Bradford, Robert L, Daniar, Mohamad, Daniel, Christel, Benoit, Vincent, Bey, Romain, Paris, Nicolas, Serre, Patricia, Orlova, Nina, Dubiel, Julien, Hilka, Martin, Jannot, Anne Sophie, Breant, Stephane, Leblanc, Judith, Griffon, Nicolas, Burgun, Anita, Bernaux, Melodie, Sandrin, Arnaud, Salamanca, Elisa, Cormont, Sylvie, Ganslandt, Thomas, Gradinger, Tobias, Champ, Julien, Boeker, Martin, Martel, Patricia, Esteve, Loic, Gramfort, Alexandre, Grisel, Olivier, Leprovost, Damien, Moreau, Thomas, Varoquaux, Gael, Vie, Jill-Jênn, Wassermann, Demian, Mensch, Arthur, Caucheteux, Charlotte, Haverkamp, Christian, Lemaitre, Guillaume, Bosari, Silvano, Krantz, Ian D, South, Andrew, Cai, Tianxi, and Kohane, Isaac S

Subjects
Health Services and Systems, Health Sciences, Good Health and Well Being, Databases, Outcomes research, Viral infection, Health services and systems
Abstract

We leveraged the largely untapped resource of electronic health record data to address critical clinical and epidemiological questions about Coronavirus Disease 2019 (COVID-19). To do this, we formed an international consortium (4CE) of 96 hospitals across five countries (www.covidclinical.net). Contributors utilized the Informatics for Integrating Biology and the Bedside (i2b2) or Observational Medical Outcomes Partnership (OMOP) platforms to map to a common data model. The group focused on temporal changes in key laboratory test values. Harmonized data were analyzed locally and converted to a shared aggregate form for rapid analysis and visualization of regional differences and global commonalities. Data covered 27,584 COVID-19 cases with 187,802 laboratory tests. Case counts and laboratory trajectories were concordant with existing literature. Laboratory tests at the time of diagnosis showed hospital-level differences equivalent to country-level variation across the consortium partners. Despite the limitations of decentralized data generation, we established a framework to capture the trajectory of COVID-19 disease in patients and their response to interventions.

Published
2020

11. Impact of a “Chart Closure” Hard Stop Alert on Prescribing for Elevated Blood Pressures Among Patients With Diabetes: Quasi-Experimental Study (Preprint)

Author

Ramirez, Magaly, Chen, Kimberly, Follett, Robert W, Mangione, Carol M, Moreno, Gerardo, and Bell, Douglas S

Subjects
Diabetes, Clinical Research, Metabolic and endocrine, Good Health and Well Being
Abstract

BACKGROUND University of California at Los Angeles Health implemented a Best Practice Advisory (BPA) alert for the initiation of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) for individuals with diabetes. The BPA alert was configured with a “chart closure” hard stop, which demanded a response before closing the chart. OBJECTIVE The aim of the study was to evaluate whether the implementation of the BPA was associated with changes in ACEI and ARB prescribing during primary care encounters for patients with diabetes. METHODS We defined ACEI and ARB prescribing opportunities as primary care encounters in which the patient had a diabetes diagnosis, elevated blood pressure in recent encounters, no active ACEI or ARB prescription, and no contraindications. We used a multivariate logistic regression model to compare the change in the probability of an ACEI or ARB prescription during opportunity encounters before and after BPA implementation in primary care sites that did (n=30) and did not (n=31) implement the BPA. In an additional subgroup analysis, we compared ACEI and ARB prescribing in BPA implementation sites that had also implemented a pharmacist-led medication management program. RESULTS We identified a total of 2438 opportunity encounters across 61 primary care sites. The predicted probability of an ACEI or ARB prescription increased significantly from 11.46% to 22.17% during opportunity encounters in BPA implementation sites after BPA implementation. However, in the subgroup analysis, we only observed a significant improvement in ACEI and ARB prescribing in BPA implementation sites that had also implemented the pharmacist-led program. Overall, the change in the predicted probability of an ACEI or ARB prescription from before to after BPA implementation was significantly greater in BPA implementation sites compared with nonimplementation sites (difference-in-differences of 11.82; P

Published
2019

12. Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium

Author

Sperotto, Francesca, primary, Gutiérrez-Sacristán, Alba, additional, Makwana, Simran, additional, Li, Xiudi, additional, Rofeberg, Valerie N., additional, Cai, Tianxi, additional, Bourgeois, Florence T., additional, Omenn, Gilbert S., additional, Hanauer, David A., additional, Sáez, Carlos, additional, Bonzel, Clara-Lea, additional, Bucholz, Emily, additional, Dionne, Audrey, additional, Elias, Matthew D., additional, García-Barrio, Noelia, additional, González, Tomás González, additional, Issitt, Richard W., additional, Kernan, Kate F., additional, Laird-Gion, Jessica, additional, Maidlow, Sarah E., additional, Mandl, Kenneth D., additional, Ahooyi, Taha Mohseni, additional, Moraleda, Cinta, additional, Morris, Michele, additional, Moshal, Karyn L., additional, Pedrera-Jiménez, Miguel, additional, Shah, Mohsin A., additional, South, Andrew M., additional, Spiridou, Anastasia, additional, Taylor, Deanne M., additional, Verdy, Guillaume, additional, Visweswaran, Shyam, additional, Wang, Xuan, additional, Xia, Zongqi, additional, Zachariasse, Joany M., additional, Newburger, Jane W., additional, Avillach, Paul, additional, Aaron, James R., additional, Adam, Atif, additional, Agapito, Giuseppe, additional, Albayrak, Adem, additional, Albi, Giuseppe, additional, Alessiani, Mario, additional, Alloni, Anna, additional, Amendola, Danilo F., additional, Angoulvant, François, additional, Anthony, Li LLJ., additional, Aronow, Bruce J., additional, Ashraf, Fatima, additional, Atz, Andrew, additional, Panickan, Vidul Ayakulangara, additional, Azevedo, Paula S., additional, Badenes, Rafael, additional, Balshi, James, additional, Batugo, Ashley, additional, Beaulieu-Jones, Brendin R., additional, Beaulieu-Jones, Brett K., additional, Bell, Douglas S., additional, Bellasi, Antonio, additional, Bellazzi, Riccardo, additional, Benoit, Vincent, additional, Beraghi, Michele, additional, Bernal-Sobrino, José Luis, additional, Bernaux, Mélodie, additional, Bey, Romain, additional, Bhatnagar, Surbhi, additional, Blanco-Martínez, Alvar, additional, Boeker, Martin, additional, Booth, John, additional, Bosari, Silvano, additional, Bradford, Robert L., additional, Brat, Gabriel A., additional, Bréant, Stéphane, additional, Brown, Nicholas W., additional, Bruno, Raffaele, additional, Bryant, William A., additional, Bucalo, Mauro, additional, Burgun, Anita, additional, Cannataro, Mario, additional, Carmona, Aldo, additional, Cattelan, Anna Maria, additional, Caucheteux, Charlotte, additional, Champ, Julien, additional, Chen, Jin, additional, Chen, Krista Y., additional, Chiovato, Luca, additional, Chiudinelli, Lorenzo, additional, Cho, Kelly, additional, Cimino, James J., additional, Colicchio, Tiago K., additional, Cormont, Sylvie, additional, Cossin, Sébastien, additional, Craig, Jean B., additional, Cruz-Bermúdez, Juan Luis, additional, Cruz-Rojo, Jaime, additional, Dagliati, Arianna, additional, Daniar, Mohamad, additional, Daniel, Christel, additional, Das, Priyam, additional, Devkota, Batsal, additional, Duan, Rui, additional, Dubiel, Julien, additional, DuVall, Scott L., additional, Esteve, Loic, additional, Estiri, Hossein, additional, Fan, Shirley, additional, Follett, Robert W., additional, Ganslandt, Thomas, additional, Garmire, Lana X., additional, Gehlenborg, Nils, additional, Getzen, Emily J., additional, Geva, Alon, additional, Goh, Rachel SJ., additional, Gradinger, Tobias, additional, Gramfort, Alexandre, additional, Griffier, Romain, additional, Griffon, Nicolas, additional, Grisel, Olivier, additional, Guzzi, Pietro H., additional, Han, Larry, additional, Haverkamp, Christian, additional, Hazard, Derek Y., additional, He, Bing, additional, Henderson, Darren W., additional, Hilka, Martin, additional, Ho, Yuk-Lam, additional, Holmes, John H., additional, Honerlaw, Jacqueline P., additional, Hong, Chuan, additional, Huling, Kenneth M., additional, Hutch, Meghan R., additional, Jannot, Anne Sophie, additional, Jouhet, Vianney, additional, Kainth, Mundeep K., additional, Kate, Kernan F., additional, Kavuluru, Ramakanth, additional, Keller, Mark S., additional, Kennedy, Chris J., additional, Key, Daniel A., additional, Kirchoff, Katie, additional, Klann, Jeffrey G., additional, Kohane, Isaac S., additional, Krantz, Ian D., additional, Kraska, Detlef, additional, Krishnamurthy, Ashok K., additional, L'Yi, Sehi, additional, Leblanc, Judith, additional, Lemaitre, Guillaume, additional, Lenert, Leslie, additional, Leprovost, Damien, additional, Liu, Molei, additional, Will Loh, Ne Hooi, additional, Long, Qi, additional, Lozano-Zahonero, Sara, additional, Luo, Yuan, additional, Lynch, Kristine E., additional, Mahmood, Sadiqa, additional, Makoudjou, Adeline, additional, Malovini, Alberto, additional, Mao, Chengsheng, additional, Maram, Anupama, additional, Maripuri, Monika, additional, Martel, Patricia, additional, Martins, Marcelo R., additional, Marwaha, Jayson S., additional, Masino, Aaron J., additional, Mazzitelli, Maria, additional, Mazzotti, Diego R., additional, Mensch, Arthur, additional, Milano, Marianna, additional, Minicucci, Marcos F., additional, Moal, Bertrand, additional, Moore, Jason H., additional, Morris, Jeffrey S., additional, Mousavi, Sajad, additional, Mowery, Danielle L., additional, Murad, Douglas A., additional, Murphy, Shawn N., additional, Naughton, Thomas P., additional, Breda Neto, Carlos Tadeu, additional, Neuraz, Antoine, additional, Newburger, Jane, additional, Ngiam, Kee Yuan, additional, Njoroge, Wanjiku FM., additional, Norman, James B., additional, Obeid, Jihad, additional, Okoshi, Marina P., additional, Olson, Karen L., additional, Orlova, Nina, additional, Ostasiewski, Brian D., additional, Palmer, Nathan P., additional, Paris, Nicolas, additional, Patel, Lav P., additional, Pfaff, Ashley C., additional, Pfaff, Emily R., additional, Pillion, Danielle, additional, Pizzimenti, Sara, additional, Priya, Tanu, additional, Prokosch, Hans U., additional, Prudente, Robson A., additional, Prunotto, Andrea, additional, Quirós-González, Víctor, additional, Ramoni, Rachel B., additional, Raskin, Maryna, additional, Rieg, Siegbert, additional, Roig-Domínguez, Gustavo, additional, Rojo, Pablo, additional, Romero-Garcia, Nekane, additional, Rubio-Mayo, Paula, additional, Sacchi, Paolo, additional, Salamanca, Elisa, additional, Samayamuthu, Malarkodi Jebathilagam, additional, Sanchez-Pinto, L. Nelson, additional, Sandrin, Arnaud, additional, Santhanam, Nandhini, additional, Santos, Janaina C.C., additional, Sanz Vidorreta, Fernando J., additional, Savino, Maria, additional, Schriver, Emily R., additional, Schubert, Petra, additional, Schuettler, Juergen, additional, Scudeller, Luigia, additional, Sebire, Neil J., additional, Serrano-Balazote, Pablo, additional, Serre, Patricia, additional, Serret-Larmande, Arnaud, additional, Hossein Abad, Zahra Shakeri, additional, Silvio, Domenick, additional, Sliz, Piotr, additional, Son, Jiyeon, additional, Sonday, Charles, additional, Sperotto, Francesca, additional, Strasser, Zachary H., additional, Tan, Amelia LM., additional, Tan, Bryce W.Q., additional, Tan, Byorn W.L., additional, Tanni, Suzana E., additional, Terriza-Torres, Ana I., additional, Tibollo, Valentina, additional, Tippmann, Patric, additional, Toh, Emma MS., additional, Torti, Carlo, additional, Trecarichi, Enrico M., additional, Vallejos, Andrew K., additional, Varoquaux, Gael, additional, Vella, Margaret E., additional, Vie, Jill-Jênn, additional, Vitacca, Michele, additional, Wagholikar, Kavishwar B., additional, Waitman, Lemuel R., additional, Wassermann, Demian, additional, Weber, Griffin M., additional, Wolkewitz, Martin, additional, Wong, Scott, additional, Xiong, Xin, additional, Ye, Ye, additional, Yehya, Nadir, additional, Yuan, William, additional, Zahner, Janet J., additional, Zambelli, Alberto, additional, Zhang, Harrison G., additional, Zöller, Daniela, additional, Zuccaro, Valentina, additional, and Zucco, Chiara, additional

Published
2023
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13. Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: an international multi-centre observational cohort study

Author

Tan, Byorn W.L., primary, Tan, Bryce W.Q., additional, Tan, Amelia L.M., additional, Schriver, Emily R., additional, Gutiérrez-Sacristán, Alba, additional, Das, Priyam, additional, Yuan, William, additional, Hutch, Meghan R., additional, García Barrio, Noelia, additional, Pedrera Jimenez, Miguel, additional, Abu-el-rub, Noor, additional, Morris, Michele, additional, Moal, Bertrand, additional, Verdy, Guillaume, additional, Cho, Kelly, additional, Ho, Yuk-Lam, additional, Patel, Lav P., additional, Dagliati, Arianna, additional, Neuraz, Antoine, additional, Klann, Jeffrey G., additional, South, Andrew M., additional, Visweswaran, Shyam, additional, Hanauer, David A., additional, Maidlow, Sarah E., additional, Liu, Mei, additional, Mowery, Danielle L., additional, Batugo, Ashley, additional, Makoudjou, Adeline, additional, Tippmann, Patric, additional, Zöller, Daniela, additional, Brat, Gabriel A., additional, Luo, Yuan, additional, Avillach, Paul, additional, Bellazzi, Riccardo, additional, Chiovato, Luca, additional, Malovini, Alberto, additional, Tibollo, Valentina, additional, Samayamuthu, Malarkodi Jebathilagam, additional, Serrano Balazote, Pablo, additional, Xia, Zongqi, additional, Loh, Ne Hooi Will, additional, Chiudinelli, Lorenzo, additional, Bonzel, Clara-Lea, additional, Hong, Chuan, additional, Zhang, Harrison G., additional, Weber, Griffin M., additional, Kohane, Isaac S., additional, Cai, Tianxi, additional, Omenn, Gilbert S., additional, Holmes, John H., additional, Ngiam, Kee Yuan, additional, Aaron, James R., additional, Agapito, Giuseppe, additional, Albayrak, Adem, additional, Albi, Giuseppe, additional, Alessiani, Mario, additional, Alloni, Anna, additional, Amendola, Danilo F., additional, Angoulvant, François, additional, Anthony, Li L.L.J., additional, Aronow, Bruce J., additional, Ashraf, Fatima, additional, Atz, Andrew, additional, Panickan, Vidul Ayakulangara, additional, Azevedo, Paula S., additional, Balshi, James, additional, Beaulieu-Jones, Brett K., additional, Beaulieu-Jones, Brendin R., additional, Bell, Douglas S., additional, Bellasi, Antonio, additional, Benoit, Vincent, additional, Beraghi, Michele, additional, Bernal-Sobrino, José Luis, additional, Bernaux, Mélodie, additional, Bey, Romain, additional, Bhatnagar, Surbhi, additional, Blanco-Martínez, Alvar, additional, Boeker, Martin, additional, Booth, John, additional, Bosari, Silvano, additional, Bourgeois, Florence T., additional, Bradford, Robert L., additional, Bréant, Stéphane, additional, Brown, Nicholas W., additional, Bruno, Raffaele, additional, Bryant, William A., additional, Bucalo, Mauro, additional, Bucholz, Emily, additional, Burgun, Anita, additional, Cannataro, Mario, additional, Carmona, Aldo, additional, Cattelan, Anna Maria, additional, Caucheteux, Charlotte, additional, Champ, Julien, additional, Chen, Jin, additional, Chen, Krista Y., additional, Cimino, James J., additional, Colicchio, Tiago K., additional, Cormont, Sylvie, additional, Cossin, Sébastien, additional, Craig, Jean B., additional, Cruz-Bermúdez, Juan Luis, additional, Cruz-Rojo, Jaime, additional, Daniar, Mohamad, additional, Daniel, Christel, additional, Devkota, Batsal, additional, Dionne, Audrey, additional, Duan, Rui, additional, Dubiel, Julien, additional, DuVall, Scott L., additional, Esteve, Loic, additional, Estiri, Hossein, additional, Fan, Shirley, additional, Follett, Robert W., additional, Ganslandt, Thomas, additional, García-Barrio, Noelia, additional, Garmire, Lana X., additional, Gehlenborg, Nils, additional, Getzen, Emily J., additional, Geva, Alon, additional, González, Tomás González, additional, Gradinger, Tobias, additional, Gramfort, Alexandre, additional, Griffier, Romain, additional, Griffon, Nicolas, additional, Grisel, Olivier, additional, Guzzi, Pietro H., additional, Han, Larry, additional, Haverkamp, Christian, additional, Hazard, Derek Y., additional, He, Bing, additional, Henderson, Darren W., additional, Hilka, Martin, additional, Honerlaw, Jacqueline P., additional, Huling, Kenneth M., additional, Issitt, Richard W., additional, Jannot, Anne Sophie, additional, Jouhet, Vianney, additional, Kavuluru, Ramakanth, additional, Keller, Mark S., additional, Kennedy, Chris J., additional, Kernan, Kate F., additional, Key, Daniel A., additional, Kirchoff, Katie, additional, Krantz, Ian D., additional, Kraska, Detlef, additional, Krishnamurthy, Ashok K., additional, L'Yi, Sehi, additional, Le, Trang T., additional, Leblanc, Judith, additional, Lemaitre, Guillaume, additional, Lenert, Leslie, additional, Leprovost, Damien, additional, Liu, Molei, additional, Will Loh, Ne Hooi, additional, Long, Qi, additional, Lozano-Zahonero, Sara, additional, Lynch, Kristine E., additional, Mahmood, Sadiqa, additional, Makwana, Simran, additional, Mandl, Kenneth D., additional, Mao, Chengsheng, additional, Maram, Anupama, additional, Maripuri, Monika, additional, Martel, Patricia, additional, Martins, Marcelo R., additional, Marwaha, Jayson S., additional, Masino, Aaron J., additional, Mazzitelli, Maria, additional, Mazzotti, Diego R., additional, Mensch, Arthur, additional, Milano, Marianna, additional, Minicucci, Marcos F., additional, Ahooyi, Taha Mohseni, additional, Moore, Jason H., additional, Moraleda, Cinta, additional, Morris, Jeffrey S., additional, Moshal, Karyn L., additional, Mousavi, Sajad, additional, Murad, Douglas A., additional, Murphy, Shawn N., additional, Naughton, Thomas P., additional, Breda Neto, Carlos Tadeu, additional, Newburger, Jane, additional, Njoroge, Wanjiku F.M., additional, Norman, James B., additional, Obeid, Jihad, additional, Okoshi, Marina P., additional, Olson, Karen L., additional, Orlova, Nina, additional, Ostasiewski, Brian D., additional, Palmer, Nathan P., additional, Paris, Nicolas, additional, Pedrera-Jiménez, Miguel, additional, Pfaff, Ashley C., additional, Pfaff, Emily R., additional, Pillion, Danielle, additional, Pizzimenti, Sara, additional, Priya, Tanu, additional, Prokosch, Hans U., additional, Prudente, Robson A., additional, Prunotto, Andrea, additional, Quirós-González, Víctor, additional, Ramoni, Rachel B., additional, Raskin, Maryna, additional, Rieg, Siegbert, additional, Roig-Domínguez, Gustavo, additional, Rojo, Pablo, additional, Rubio-Mayo, Paula, additional, Sacchi, Paolo, additional, Sáez, Carlos, additional, Salamanca, Elisa, additional, Sanchez-Pinto, L. Nelson, additional, Sandrin, Arnaud, additional, Santhanam, Nandhini, additional, Santos, Janaina C.C., additional, Sanz Vidorreta, Fernando J., additional, Savino, Maria, additional, Schubert, Petra, additional, Schuettler, Juergen, additional, Scudeller, Luigia, additional, Sebire, Neil J., additional, Serrano-Balazote, Pablo, additional, Serre, Patricia, additional, Serret-Larmande, Arnaud, additional, Shah, Mohsin, additional, Hossein Abad, Zahra Shakeri, additional, Silvio, Domenick, additional, Sliz, Piotr, additional, Son, Jiyeon, additional, Sonday, Charles, additional, Sperotto, Francesca, additional, Spiridou, Anastasia, additional, Strasser, Zachary H., additional, Tan, Byorn W.L., additional, Tanni, Suzana E., additional, Taylor, Deanne M., additional, Terriza-Torres, Ana I., additional, Toh, Emma M.S., additional, Torti, Carlo, additional, Trecarichi, Enrico M., additional, Vallejos, Andrew K., additional, Varoquaux, Gael, additional, Vella, Margaret E., additional, Vie, Jill-Jênn, additional, Vitacca, Michele, additional, Wagholikar, Kavishwar B., additional, Waitman, Lemuel R., additional, Wang, Xuan, additional, Wassermann, Demian, additional, Wolkewitz, Martin, additional, Wong, Scott, additional, Xiong, Xin, additional, Ye, Ye, additional, Yehya, Nadir, additional, Zachariasse, Joany M., additional, Zahner, Janet J., additional, Zambelli, Alberto, additional, Zuccaro, Valentina, additional, and Zucco, Chiara, additional

Published
2023
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14. International comparisons of laboratory values from the 4CE collaborative to predict COVID-19 mortality

Author

Weber, Griffin, Hong, Chuan, Xia, Zongqi, Palmer, Nathan, Avillach, Paul, L’yi, Sehi, Keller, Mark, Murphy, Shawn, Gutiérrez-Sacristán, Alba, Bonzel, Clara-Lea, Serret-Larmande, Arnaud, Neuraz, Antoine, Omenn, Gilbert, Visweswaran, Shyam, Klann, Jeffrey, South, Andrew, Loh, Ne Hooi Will, Cannataro, Mario, Beaulieu-Jones, Brett, Bellazzi, Riccardo, Agapito, Giuseppe, Alessiani, Mario, Aronow, Bruce, Bell, Douglas, Benoit, Vincent, Bourgeois, Florence, Chiovato, Luca, Cho, Kelly, Dagliati, Arianna, Duvall, Scott, Barrio, Noelia García, Hanauer, David, Ho, Yuk-Lam, Holmes, John, Issitt, Richard, Liu, Molei, Luo, Yuan, Lynch, Kristine, Maidlow, Sarah, Malovini, Alberto, Mandl, Kenneth, Mao, Chengsheng, Matheny, Michael, Moore, Jason, Morris, Jeffrey, Morris, Michele, Mowery, Danielle, Ngiam, Kee Yuan, Patel, Lav, Pedrera Jiménez, Miguel, Ramoni, Rachel, Schriver, Emily, Schubert, Petra, Balazote, Pablo Serrano, Spiridou, Anastasia, Tan, Amelia, Tan, Byorn, Tibollo, Valentina, Torti, Carlo, Trecarichi, Enrico, Wang, Xuan, Aaron, James, Albayrak, Adem, Albi, Giuseppe, Balshi, James, Alloni, Anna, Amendola, Danilo, Angoulvant, François, Anthony, Li, Ashraf, Fatima, Atz, Andrew, Azevedo, Paula, Bellasi, Antonio, Beraghi, Michele, Bernal-Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Bhatnagar, Surbhi, Blanco-Martínez, Alvar, Boeker, Martin, Booth, John, Bosari, Silvano, Bradford, Robert, Brat, Gabriel, Bréant, Stéphane, Brown, Nicholas, Bruno, Raffaele, Bryant, William, Bucalo, Mauro, Bucholz, Emily, Burgun, Anita, Cai, Tianxi, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Krista, Chen, Jin, Chiudinelli, Lorenzo, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, Cossin, Sébastien, Craig, Jean, Cruz-Bermúdez, Juan Luis, Cruz-Rojo, Jaime, Daniar, Mohamad, Daniel, Christel, Das, Priyam, Devkota, Batsal, Garmire, Lana, Dionne, Audrey, Duan, Rui, Dubiel, Julien, Esteve, Loic, Estiri, Hossein, Fan, Shirley, Follett, Robert, Ganslandt, Thomas, García-Barrio, Noelia, Gehlenborg, Nils, Getzen, Emily, Geva, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Han, Larry, Haverkamp, Christian, Key, Daniel, Hazard, Derek, He, Bing, Henderson, Darren, Hilka, Martin, Huling, Kenneth, Hutch, Meghan, Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Kennedy, Chris, Kernan, Kate, Kirchoff, Katie, Kohane, Isaac, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, Le, Trang, Leblanc, Judith, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Long, Qi, Lozano-Zahonero, Sara, Mahmood, Sadiqa, Makoudjou, Adeline, Maram, Anupama, Martel, Patricia, Martins, Marcelo, Marwaha, Jayson, Masino, Aaron, Mazzitelli, Maria, Mensch, Arthur, Milano, Marianna, Minicucci, Marcos, Moal, Bertrand, Ahooyi, Taha Mohseni, Moraleda, Cinta, Moshal, Karyn, Mousavi, Sajad, Murad, Douglas, Naughton, Thomas, Neto, Carlos Tadeu Breda, Newburger, Jane, Njoroge, Wanjiku, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Orlova, Nina, Ostasiewski, Brian, Paris, Nicolas, Pedrera-Jiménez, Miguel, Pfaff, Ashley, Pfaff, Emily, Pillion, Danielle, Pizzimenti, Sara, Prokosch, Hans, Prudente, Robson, Prunotto, Andrea, Quirós-González, Víctor, Raskin, Maryna, Rieg, Siegbert, Roig-Domínguez, Gustavo, Rojo, Pablo, Rubio-Mayo, Paula, Sacchi, Paolo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi Jebathilagam, Sanchez-Pinto, L. Nelson, Sandrin, Arnaud, Santhanam, Nandhini, Santos, Janaina, Sanz Vidorreta, Fernando, Savino, Maria, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil, Serrano-Balazote, Pablo, Serre, Patricia, Shah, Mohsin, Abad, Zahra Shakeri Hossein, Silvio, Domenick, Sliz, Piotr, Son, Jiyeon, Sonday, Charles, Sperotto, Francesca, Strasser, Zachary, Tan, Bryce, Tanni, Suzana, Taylor, Deanne, Terriza-Torres, Ana, Tippmann, Patric, Toh, Emma, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vella, Margaret, Verdy, Guillaume, Vie, Jill-Jênn, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wassermann, Demian, Wolkewitz, Martin, Wong, Scott, Xiong, Xin, Ye, Ye, Yehya, Nadir, Yuan, William, Zambelli, Alberto, Zhang, Harrison, Zöller, Daniela, Zuccaro, Valentina, Zucco, Chiara, Harvard Medical School [Boston] (HMS), University of Pittsburgh (PITT), Pennsylvania Commonwealth System of Higher Education (PCSHE), Massachusetts General Hospital [Boston], Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), University of Michigan [Ann Arbor], University of Michigan System, Wake Forest School of Medicine [Winston-Salem], Wake Forest Baptist Medical Center, National University Health System [Singapore] (NUHS), Università degli Studi 'Magna Graecia' di Catanzaro = University of Catanzaro (UMG), Università degli Studi di Pavia = University of Pavia (UNIPV), Istituti Clinici Scientifici Maugeri [Pavia] (IRCCS Pavia - ICS Maugeri), ASST Pavia, University of Cincinnati (UC), University of California [Los Angeles] (UCLA), University of California (UC), VA Boston Healthcare System, Hospital Universitario 12 de Octubre [Madrid], University of Pennsylvania, Great Ormond Street Hospital for Children [London] (GOSH), Harvard School of Public Health, Northwestern University [Chicago, Ill. USA], VA Salt Lake City Health Care System, Boston Children's Hospital, University of Kansas [Kansas City], and National University Hospital [Singapore] (NUH)

Subjects
Health Information Management, Medicine (miscellaneous), Health Informatics, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Computer Science Applications
Abstract

Given the growing number of prediction algorithms developed to predict COVID-19 mortality, we evaluated the transportability of a mortality prediction algorithm using a multi-national network of healthcare systems. We predicted COVID-19 mortality using baseline commonly measured laboratory values and standard demographic and clinical covariates across healthcare systems, countries, and continents. Specifically, we trained a Cox regression model with nine measured laboratory test values, standard demographics at admission, and comorbidity burden pre-admission. These models were compared at site, country, and continent level. Of the 39,969 hospitalized patients with COVID-19 (68.6% male), 5717 (14.3%) died. In the Cox model, age, albumin, AST, creatine, CRP, and white blood cell count are most predictive of mortality. The baseline covariates are more predictive of mortality during the early days of COVID-19 hospitalization. Models trained at healthcare systems with larger cohort size largely retain good transportability performance when porting to different sites. The combination of routine laboratory test values at admission along with basic demographic features can predict mortality in patients hospitalized with COVID-19. Importantly, this potentially deployable model differs from prior work by demonstrating not only consistent performance but also reliable transportability across healthcare systems in the US and Europe, highlighting the generalizability of this model and the overall approach.

Published
2022
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15. Evolving phenotypes of non-hospitalized patients that indicate long COVID

Author

ESTIRI, Hossein, Strasser, Zachary, Brat, Gabriel, Semenov, Yevgeniy, Patel, Chirag, Murphy, Shawn, Aaron, James, Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo, Anthony, Li, Aronow, Bruce, Ashraf, Fatima, Atz, Andrew, Avillach, Paul, Balshi, James, Beaulieu-Jones, Brett, Bell, Douglas, Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Sobrino, José Luis Bernal, Bernaux, Mélodie, Bey, Romain, Martínez, Alvar Blanco, Boeker, Martin, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence, Bradford, Robert, Bréant, Stéphane, Brown, Nicholas, Bryant, William, Bucalo, Mauro, Burgun, Anita, Cai, Tianxi, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Jin, Chen, Krista, Chiovato, Luca, Chiudinelli, Lorenzo, Cho, Kelly, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, COSSIN, Sébastien, Craig, Jean, Bermúdez, Juan Luis Cruz, Rojo, Jaime Cruz, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Devkota, Batsal, Dubiel, Julien, Esteve, Loic, Fan, Shirley, Follett, Robert, Gaiolla, Paula, Ganslandt, Thomas, Barrio, Noelia García, Garmire, Lana, Gehlenborg, Nils, GEVA, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Gutiérrez-Sacristán, Alba, Hanauer, David, Haverkamp, Christian, He, Bing, Henderson, Darren, Hilka, Martin, Holmes, John, Hong, Chuan, Horki, Petar, Huling, Kenneth, HUTCH, Meghan, Issitt, Richard, Jannot, Anne Sophie, Jouhet, Vianney, Keller, Mark, Kirchoff, Katie, Klann, Jeffrey, Kohane, Isaac, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, L’Yi, Sehi, Le, Trang, Leblanc, Judith, Leite, Andressa, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, LOH, Ne Hooi Will, Lozano-Zahonero, Sara, Luo, Yuan, Lynch, Kristine, Mahmood, Sadiqa, Maidlow, Sarah, Malovini, Alberto, Mandl, Kenneth, Mao, Chengsheng, Maram, Anupama, Martel, Patricia, Masino, Aaron, Mazzitelli, Maria, Mensch, Arthur, Milano, Marianna, Minicucci, Marcos, Moal, Bertrand, Moore, Jason, Moraleda, Cinta, Morris, Jeffrey, MORRIS, Michele, Moshal, Karyn, Mousavi, Sajad, Mowery, Danielle, Murad, Douglas, Naughton, Thomas, Neuraz, Antoine, Ngiam, Kee Yuan, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Omenn, Gilbert, Orlova, Nina, Ostasiewski, Brian, Palmer, Nathan, Paris, Nicolas, Patel, Lav, Jimenez, Miguel Pedrera, Pfaff, Emily, Pillion, Danielle, Prokosch, Hans, Prudente, Robson, González, Víctor Quirós, Ramoni, Rachel, Raskin, Maryna, RIEG, Siegbert, Domínguez, Gustavo Roig, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi, Sandrin, Arnaud, Santos, Janaina, Savino, Maria, SCHRIVER, Emily, Schubert, Petra, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil, Balazote, Pablo Serrano, Serre, Patricia, Serret-Larmande, Arnaud, Shakeri, Zahra, Silvio, Domenick, Sliz, Piotr, SON, Jiyeon, Sonday, Charles, South, Andrew, Spiridou, Anastasia, Tan, Amelia, Tan, Bryce, Tan, Byorn, Tanni, Suzana, Taylor, Deanne, Terriza Torres, Ana, Tibollo, Valentina, Tippmann, Patric, Torti, Carlo, Trecarichi, Enrico, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vella, Margaret, Verdy, Guillaume, Vie, Jill-Jênn, Visweswaran, Shyam, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wang, Xuan, Wassermann, Demian, Weber, Griffin, XIA, Zongqi, Yehya, Nadir, Yuan, William, Zambelli, Alberto, Zhang, Harrison, Zoeller, Daniel, Zucco, Chiara, Massachusetts General Hospital [Boston], Harvard Medical School [Boston] (HMS), Service d'informatique médicale et biostatistiques [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), Université Paris Cité (UPC), This work was supported by the National Human Genome Research Institute grant 3U01HG008685-05S2 and the National Library of Medicine grant T15LM007092., École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), and Université Paris Cité (UPCité)

Subjects
medicine.medical_specialty, Neurological disorder, Chest pain, MESH: Phenotype, Article, 03 medical and health sciences, 0302 clinical medicine, Post-Acute COVID-19 Syndrome, Diabetes mellitus, Internal medicine, Machine learning, medicine, Chronic fatigue syndrome, Humans, Electronic health records, Post-acute sequelae of SARS-CoV-2, MESH: COVID-19, 030304 developmental biology, Retrospective Studies, 0303 health sciences, MESH: Humans, business.industry, Medical record, Type 2 Diabetes Mellitus, COVID-19, Retrospective cohort study, MESH: Retrospective Studies, General Medicine, medicine.disease, 3. Good health, Dysgeusia, Phenotypes, Phenotype, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business, 030217 neurology & neurosurgery, Research Article, Cohort study
Abstract

Background For some SARS-CoV-2 survivors, recovery from the acute phase of the infection has been grueling with lingering effects. Many of the symptoms characterized as the post-acute sequelae of COVID-19 (PASC) could have multiple causes or are similarly seen in non-COVID patients. Accurate identification of PASC phenotypes will be important to guide future research and help the healthcare system focus its efforts and resources on adequately controlled age- and gender-specific sequelae of a COVID-19 infection. Methods In this retrospective electronic health record (EHR) cohort study, we applied a computational framework for knowledge discovery from clinical data, MLHO, to identify phenotypes that positively associate with a past positive reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19. We evaluated the post-test phenotypes in two temporal windows at 3–6 and 6–9 months after the test and by age and gender. Data from longitudinal diagnosis records stored in EHRs from Mass General Brigham in the Boston Metropolitan Area was used for the analyses. Statistical analyses were performed on data from March 2020 to June 2021. Study participants included over 96 thousand patients who had tested positive or negative for COVID-19 and were not hospitalized. Results We identified 33 phenotypes among different age/gender cohorts or time windows that were positively associated with past SARS-CoV-2 infection. All identified phenotypes were newly recorded in patients’ medical records 2 months or longer after a COVID-19 RT-PCR test in non-hospitalized patients regardless of the test result. Among these phenotypes, a new diagnosis record for anosmia and dysgeusia (OR 2.60, 95% CI [1.94–3.46]), alopecia (OR 3.09, 95% CI [2.53–3.76]), chest pain (OR 1.27, 95% CI [1.09–1.48]), chronic fatigue syndrome (OR 2.60, 95% CI [1.22–2.10]), shortness of breath (OR 1.41, 95% CI [1.22–1.64]), pneumonia (OR 1.66, 95% CI [1.28–2.16]), and type 2 diabetes mellitus (OR 1.41, 95% CI [1.22–1.64]) is one of the most significant indicators of a past COVID-19 infection. Additionally, more new phenotypes were found with increased confidence among the cohorts who were younger than 65. Conclusions The findings of this study confirm many of the post-COVID-19 symptoms and suggest that a variety of new diagnoses, including new diabetes mellitus and neurological disorder diagnoses, are more common among those with a history of COVID-19 than those without the infection. Additionally, more than 63% of PASC phenotypes were observed in patients under 65 years of age, pointing out the importance of vaccination to minimize the risk of debilitating post-acute sequelae of COVID-19 among younger adults.

Published
2021
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16. Authorship Correction: International Changes in COVID-19 Clinical Trajectories Across 315 Hospitals and 6 Countries: Retrospective Cohort Study

Author

Weber, Griffin M, Zhang, Harrison G, L'Yi, Sehi, Bonzel, Clara-Lea, Hong, Chuan, Avillach, Paul, Gutiérrez-Sacristán, Alba, Palmer, Nathan P, Tan, Amelia Li Min, Wang, Xuan, Yuan, William, Gehlenborg, Nils, Alloni, Anna, Amendola, Danilo F, Bellasi, Antonio, Bellazzi, Riccardo, Beraghi, Michele, Bucalo, Mauro, Chiovato, Luca, Cho, Kelly, Dagliati, Arianna, Estiri, Hossein, Follett, Robert W, García Barrio, Noelia, Hanauer, David A, Henderson, Darren W, Ho, Yuk-Lam, Holmes, John H, Hutch, Meghan R, Kavuluru, Ramakanth, Kirchoff, Katie, Klann, Jeffrey G, Krishnamurthy, Ashok K, Le, Trang T, Liu, Molei, Loh, Ne Hooi Will, Lozano-Zahonero, Sara, Luo, Yuan, Maidlow, Sarah, Makoudjou, Adeline, Malovini, Alberto, Martins, Marcelo Roberto, Moal, Bertrand, Morris, Michele, Mowery, Danielle L, Murphy, Shawn N, Neuraz, Antoine, Ngiam, Kee Yuan, Okoshi, Marina P, Omenn, Gilbert S, Patel, Lav P, Pedrera Jiménez, Miguel, Prudente, Robson A, Samayamuthu, Malarkodi Jebathilagam, Sanz Vidorreta, Fernando J, Schriver, Emily R, Schubert, Petra, Serrano Balazote, Pablo, Tan, Byorn WL, Tanni, Suzana E, Tibollo, Valentina, Visweswaran, Shyam, Wagholikar, Kavishwar B, Xia, Zongqi, Zöller, Daniela, Kohane, Isaac S, Cai, Tianxi, South, Andrew M, and Brat, Gabriel A

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, SARS-CoV-2, COVID-19, Health Informatics, Retrospective cohort study, Middle Aged, Corrigenda and Addenda, Hospitals, Hospitalization, Family medicine, medicine, Humans, Female, business, Pandemics, Aged, Retrospective Studies
Abstract

Many countries have experienced 2 predominant waves of COVID-19-related hospitalizations. Comparing the clinical trajectories of patients hospitalized in separate waves of the pandemic enables further understanding of the evolving epidemiology, pathophysiology, and health care dynamics of the COVID-19 pandemic.In this retrospective cohort study, we analyzed electronic health record (EHR) data from patients with SARS-CoV-2 infections hospitalized in participating health care systems representing 315 hospitals across 6 countries. We compared hospitalization rates, severe COVID-19 risk, and mean laboratory values between patients hospitalized during the first and second waves of the pandemic.Using a federated approach, each participating health care system extracted patient-level clinical data on their first and second wave cohorts and submitted aggregated data to the central site. Data quality control steps were adopted at the central site to correct for implausible values and harmonize units. Statistical analyses were performed by computing individual health care system effect sizes and synthesizing these using random effect meta-analyses to account for heterogeneity. We focused the laboratory analysis on C-reactive protein (CRP), ferritin, fibrinogen, procalcitonin, D-dimer, and creatinine based on their reported associations with severe COVID-19.Data were available for 79,613 patients, of which 32,467 were hospitalized in the first wave and 47,146 in the second wave. The prevalence of male patients and patients aged 50 to 69 years decreased significantly between the first and second waves. Patients hospitalized in the second wave had a 9.9% reduction in the risk of severe COVID-19 compared to patients hospitalized in the first wave (95% CI 8.5%-11.3%). Demographic subgroup analyses indicated that patients aged 26 to 49 years and 50 to 69 years; male and female patients; and black patients had significantly lower risk for severe disease in the second wave than in the first wave. At admission, the mean values of CRP were significantly lower in the second wave than in the first wave. On the seventh hospital day, the mean values of CRP, ferritin, fibrinogen, and procalcitonin were significantly lower in the second wave than in the first wave. In general, countries exhibited variable changes in laboratory testing rates from the first to the second wave. At admission, there was a significantly higher testing rate for D-dimer in France, Germany, and Spain.Patients hospitalized in the second wave were at significantly lower risk for severe COVID-19. This corresponded to mean laboratory values in the second wave that were more likely to be in typical physiological ranges on the seventh hospital day compared to the first wave. Our federated approach demonstrated the feasibility and power of harmonizing heterogeneous EHR data from multiple international health care systems to rapidly conduct large-scale studies to characterize how COVID-19 clinical trajectories evolve.

Published
2021

17. Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19

Author

Le, Trang, Gutiérrez-Sacristán, Alba, Son, Jiyeon, Hong, Chuan, South, Andrew, Beaulieu-Jones, Brett, Loh, Ne Hooi Will, Luo, Yuan, Morris, Michele, Ngiam, Kee Yuan, Patel, Lav, Samayamuthu, Malarkodi, Schriver, Emily, Tan, Amelia, Moore, Jason, Cai, Tianxi, Omenn, Gilbert, Avillach, Paul, Kohane, Isaac, Visweswaran, Shyam, Mowery, Danielle, Xia, Zongqi, Aaron, James, Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo, Angoulvant, François, Anthony, Li, Aronow, Bruce, Atz, Andrew, Balshi, James, Bell, Douglas, Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Blanco Martínez, Alvar, Boeker, Martin, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence, Bradford, Robert, Brat, Gabriel, Bréant, Stéphane, Brown, Nicholas, Bryant, William, Bucalo, Mauro, Burgun, Anita, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Krista, Chen, Jin, Chiovato, Luca, Chiudinelli, Lorenzo, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, Cossin, Sébastien, Craig, Jean, Cruz Bermúdez, Juan Luis, Cruz Rojo, Jaime, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Devkota, Batsal, Dubiel, Julien, Esteve, Loic, Fan, Shirley, Follett, Robert, Gaiolla, Paula, Ganslandt, Thomas, García Barrio, Noelia, Garmire, Lana, Gehlenborg, Nils, Geva, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Hanauer, David, Haverkamp, Christian, He, Bing, Henderson, Darren, Hilka, Martin, Holmes, John, Horki, Petar, Huling, Kenneth, Hutch, Meghan, Issitt, Richard, Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Keller, Mark, Kirchoff, Katie, Klann, Jeffrey, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, L’yi, Sehi, Leblanc, Judith, Leite, Andressa, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, Lozano-Zahonero, Sarah, Lynch, Kristine, Mahmood, Sadiqa, Maidlow, Sarah, Makoudjou Tchendjou, Adeline, Malovini, Alberto, Mandl, Kenneth, Mao, Chengsheng, Maram, Anupama, Martel, Patricia, Masino, Aaron, Matheny, Michael, Maulhardt, Thomas, Mazzitelli, Maria, Mcduffie, Michael, Mensch, Arthur, Ashraf, Fatima, Milano, Marianna, Minicucci, Marcos, Moal, Bertrand, Moraleda, Cinta, Morris, Jeffrey, Moshal, Karyn, Mousavi, Sajad, Murad, Douglas, Murphy, Shawn, Naughton, Thomas, Neuraz, Antoine, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Orlova, Nina, Ostasiewski, Brian, Palmer, Nathan, Paris, Nicolas, Pedrera Jimenez, Miguel, Pfaff, Emily, Pillion, Danielle, Prokosch, Hans, Prudente, Robson, Quirós González, Víctor, Ramoni, Rachel, Raskin, Maryna, Rieg, Siegbert, Roig Domínguez, Gustavo, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Sandrin, Arnaud, Santos, Janaina, Savino, Maria, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil, Balazote, Pablo Serrano, Serre, Patricia, Serret-Larmande, Arnaud, Shakeri, Zahra, Silvio, Domenick, Sliz, Piotr, Sonday, Charles, Spiridou, Anastasia, Tan, Bryce, Tan, Byorn, Tanni, Suzana, Taylor, Deanne, Terriza-Torres, Ana, Tibollo, Valentina, Tippmann, Patric, Torti, Carlo, Trecarichi, Enrico, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vella, Margaret, Vie, Jill-Jênn, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wassermann, Demian, Weber, Griffin, William, Yuan, Yehya, Nadir, Zambelli, Alberto, Zhang, Harrison, Zoeller, Daniela, Zucco, Chiara, Unité d'informatique médicale, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), AS is funded by National Institutes of Health (NIH) National Heart Lung, and Blood Institute (NHLBI) K23HL148394 and L40HL148910, and NIH-National Center for Advancing Translational Sciences (NCATS) UL1TR001420. JM is funded by NIH-National Institute of Allergy and Infectious Disease (NIAD) AI11679. LP is funded by NCATS Clinical and Translational Science Award (CTSA) Number UL1TR002366. GO is funded by NIH National Institute of Environmental Health Sciences (NIEHS) P30ES017885 and National Cancer Institute (NCI) U24CA210967. SV is funded by NIH-National Library of Medicine (NLM) R01LM012095 and NCATS UL1TR001857. DM is funded by NCATS CTSA Number UL1-TR001878. ZX is funded by NIH National Institute of Neurological Disorders and Stroke (NINDS) R01NS098023., Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), National Cancer Institute, École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), University of Pennsylvania Perelman School of Medicine, Harvard Medical School, University of Pittsburgh, Wake Forest School of Medicine, National University Health Systems, Northwestern University, University of Kansas Medical Center, University of Pennsylvania Health System, University of Michigan, University of Kentucky, University Magna Graecia of Catanzaro, INC., Lombardia Region Health System, Universidade Estadual Paulista (UNESP), Assistance Publique-Hôpitaux de Paris, Tan Tock Seng Hospital, University of Cincinnati, Medical University of South Carolina, St. Luke’s University Health Network, David Geffen School of Medicine at UCLA, ASST Papa Giovanni XXIII, University of Pavia, APHP Greater Paris University Hospital, ASST Pavia, Hospital Universitario, University of Freiburg, Informatics and Virtual Environments (DRIVE), IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, University of North Carolina, BIOMERIS (BIOMedical Research Informatics Solutions), CEA, LIRMM, Boston Children’s Hospital, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, University of Alabama at Birmingham, Bordeaux University Hospital/ERIAS-Inserm U1219 BPH, Children’s Hospital of Philadelphia, Inria Centre de Paris, Heidelberg University, and Pain Medicine Boston Children’s Hospital, University of Michigan Medical School, MSHI Medical University of South Carolina, Massachusetts General Hospital, The Children’s Hospital of Philadelphia, University Hospital, Clevy.io, Harvard T.H. Chan School of Public Health, VA Salt Lake City Health Care System, Veterans Affairs Medical Center, PSL Université Paris, School of Biomedical Informatics, Great Ormond Street Hospital for Children, University of Erlangen-Nürnberg, Office of Research and Development, Universitat Politècnica de València, Nurse Department of FMB-Medicine School of Botucatu, FAU Erlangen-Nürnberg, National University Hospital, Chang Gung University, Medical College of Wisconsin, McGill University, Inria Lille, ICS S Maugeri IRCCS, University of Missouri, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), and Université Paris Cité (UPC)

Subjects
Male, Epidemiology, Cross-sectional study, Disease, Severity of Illness Index, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Child, Prevalence, MESH: COVID-19, 030212 general & internal medicine, Young adult, Child, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Multidisciplinary, MESH: Infant, Newborn, Middle Aged, MESH: Infant, 3. Good health, Neurology, MESH: Young Adult, Child, Preschool, Medicine, Female, Encephalitis, Adult, MESH: Pandemics, medicine.medical_specialty, Adolescent, Science, Myelitis, MESH: Nervous System Diseases, Article, Young Adult, 03 medical and health sciences, Medical research, MESH: Cross-Sectional Studies, MESH: Severity of Illness Index, Internal medicine, Severity of illness, medicine, Humans, Pandemics, MESH: Prevalence, Aged, MESH: Adolescent, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, Newborn, COVID-19, Infant, MESH: Adult, medicine.disease, MESH: Male, Confidence interval, Cross-Sectional Studies, Relative risk, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Nervous System Diseases, business, MESH: Female, Neurological disorders, 030217 neurology & neurosurgery
Abstract

Made available in DSpace on 2022-04-29T08:35:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-01 Division of Intramural Research, National Institute of Allergy and Infectious Diseases Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases National Institute of Allergy and Infectious Diseases National Center for Advancing Translational Sciences National Heart, Lung, and Blood Institute National Institute of Environmental Health Sciences U.S. National Library of Medicine National Institute of Neurological Disorders and Stroke Division of Cancer Prevention, National Cancer Institute Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participating hospitals across 6 countries and 3 continents (January–September 2020) for a cross-sectional analysis. We assessed the frequency of International Classification of Disease code of neurological conditions by countries, healthcare systems, time before and after admission for COVID-19 and COVID-19 severity. Among 35,177 hospitalized patients with SARS-CoV-2 infection, there was an increase in the proportion with disorders of consciousness (5.8%, 95% confidence interval [CI] 3.7–7.8%, pFDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, pFDR < 0.001) when compared to the pre-admission proportion. During hospitalization, the relative risk of disorders of consciousness (22%, 19–25%), cerebrovascular diseases (24%, 13–35%), nontraumatic intracranial hemorrhage (34%, 20–50%), encephalitis and/or myelitis (37%, 17–60%) and myopathy (72%, 67–77%) were higher for patients with severe COVID-19 when compared to those who never experienced severe COVID-19. Leveraging a multinational network to capture standardized EHR data, we highlighted the increased prevalence of central and peripheral neurological phenotypes in patients hospitalized with COVID-19, particularly among those with severe disease. Department of Biostatistics Epidemiology and Informatics University of Pennsylvania Perelman School of Medicine Department of Biomedical Informatics Harvard Medical School Department of Neurology University of Pittsburgh, Biomedical Science Tower 3, Suite 7014, 3501 5th Avenue Department of Pediatrics Wake Forest School of Medicine Department of Critical Care National University Health Systems Department of Preventive Medicine Northwestern University Department of Biomedical Informatics University of Pittsburgh Department of Surgery National University Health Systems Department of Internal Medicine University of Kansas Medical Center Data Analytics Center University of Pennsylvania Health System Department of Computational Medicine and Bioinformatics University of Michigan Department of Biomedical Informatics University of Kentucky Department of Legal Economic and Social Sciences University Magna Graecia of Catanzaro Health Catalyst INC. Department of Surgery ASST Pavia Lombardia Region Health System Clinical Research Unit of Botucatu Medical School São Paulo State University Pediatric Emergency Department Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris National Center for Infectious Diseases Tan Tock Seng Hospital Departments of Biomedical Informatics Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati Department of Pediatrics Medical University of South Carolina Department of Surgery St. Luke’s University Health Network Department of Medicine David Geffen School of Medicine at UCLA UOC Ricerca Innovazione e Brand Reputation ASST Papa Giovanni XXIII Department of Electrical Computer and Biomedical Engineering University of Pavia IT Department Innovation & Data APHP Greater Paris University Hospital I.T. Department ASST Pavia Health Informatics Hospital Universitario, 12 de Octubre Strategy and Transformation Department APHP Greater Paris University Hospital Faculty of Medicine and Medical Center University of Freiburg Digital Research Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children Scientific Direction IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano North Carolina Translational and Clinical Sciences (NC TraCS) Institute University of North Carolina BIOMERIS (BIOMedical Research Informatics Solutions) Department of Biomedical Informatics HEGP APHP Greater Paris University Hospital Department of Medical and Surgical Sciences Data Analytics Research Center University Magna Graecia of Catanzaro Department of Anesthesia St. Luke’s University Health Network Université Paris-Saclay Inria CEA INRIA Sophia-Antipolis–ZENITH Team LIRMM Computational Health Informatics Program Boston Children’s Hospital Department of Internal Medicine University of Kentucky Unit of Internal Medicine and Endocrinology Istituti Clinici Scientifici Maugeri SpA SB IRCCS Department of Internal Medicine and Therapeutics University of Pavia Informatics Institute University of Alabama at Birmingham IAM Unit Bordeaux University Hospital/ERIAS-Inserm U1219 BPH Biomedical Informatics Center Medical University of South Carolina Clinical Research Informatics Boston Children’s Hospital Department of Biomedical and Health Informatics Children’s Hospital of Philadelphia SED/SIERRA Inria Centre de Paris Health Information Technology & Services University of Michigan Internal Medicine Department Botucatu Medical School São Paulo State University Heinrich-Lanz-Center for Digital Health University Medicine Mannheim Heidelberg University Department of Anesthesiology Critical Care and Pain Medicine Boston Children’s Hospital Department of Learning Health Sciences University of Michigan Medical School MSHI Medical University of South Carolina Department of Medicine Massachusetts General Hospital Division of Human Genetics Department of Pediatrics The Children’s Hospital of Philadelphia Center for Medical Information and Communication Technology University Hospital Renaissance Computing Institute/Department of Computer Science University of North Carolina Clinical Research Unit Saint Antoine Hospital APHP Greater Paris University Hospital Clevy.io Department of Biostatistics Harvard T.H. Chan School of Public Health VA Informatics and Computing Infrastructure VA Salt Lake City Health Care System MICHR Informatics University of Michigan Laboratory of Informatics and Systems Engineering for Clinical Research Istituti Clinici Scientifici Maugeri SpA SB IRCCS Harvard Catalyst Harvard Medical School Clinical Research Unit Paris Saclay APHP Greater Paris University Hospital Department of Anesthesiology and Critical Care Children’s Hospital of Philadelphia VA Informatics and Computing Infrastructure Tennessee Valley Healthcare System Veterans Affairs Medical Center École Normale Supérieure PSL Université Paris BIG-ARC The University of Texas Health Science Center at Houston School of Biomedical Informatics Pediatric Infectious Disease Department Hospital Universitario, 12 de Octubre Department of Infectious Diseases Great Ormond Street Hospital for Children Department of Neurology Massachusetts General Hospital Internal Medicine Department of Botucatu Medical School São Paulo State University Department of Pediatrics Boston Children’s Hospital Center for Biomedical Informatics Wake Forest School of Medicine Department of Medical Informatics University of Erlangen-Nürnberg Department of Veterans Affairs Office of Research and Development Biomedical Data Science Lab ITACA Institute Universitat Politècnica de València Nurse Department of FMB-Medicine School of Botucatu Management Engineering ASST Pavia Lombardia Region Health System Department of Anesthesiology University Hospital Erlangen FAU Erlangen-Nürnberg Critical Care Medicine Department of Medicine St. Luke’s University Health Network Department of Medicine National University Hospital Department of Information Management Chang Gung University Clinical & Translational Science Institute Medical College of Wisconsin Montréal Neurological Institute McGill University SequeL Inria Lille Respiratory Department ICS S Maugeri IRCCS Department of Health Management and Informatics University of Missouri Department of Oncology ASST Papa Giovanni XXIII Clinical Research Unit of Botucatu Medical School São Paulo State University Internal Medicine Department Botucatu Medical School São Paulo State University Internal Medicine Department of Botucatu Medical School São Paulo State University Division of Intramural Research, National Institute of Allergy and Infectious Diseases: AI11679 Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases: AI11679 National Institute of Allergy and Infectious Diseases: AI11679 National Center for Advancing Translational Sciences: CTSA Award #UL1TR001878 National Center for Advancing Translational Sciences: CTSA Award #UL1TR002366 National Heart, Lung, and Blood Institute: K23HL148394 National Institute of Environmental Health Sciences: P30ES017885 U.S. National Library of Medicine: R01LM012095 National Institute of Neurological Disorders and Stroke: R01NS098023 Division of Cancer Prevention, National Cancer Institute: U24CA210967 National Center for Advancing Translational Sciences: UL1TR001420 National Center for Advancing Translational Sciences: UL1TR001857

Published
2021
Full Text
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18. Some Questions on Accountability.

Author

Follett, Robert J. R.

Abstract

An educational publisher poses several questions that are related to accountability for the purpose of stimulating discussion on this topic at a national convention of social studies teachers. Is it appropriate to insist upon the verification or validation of instructional materials? Is it possible to make more money available for the purchase of instructional materials? Will schools ever share with publishers control over items such as pupil assignment, teacher assignment, or time allocation? Are educators responsible in any way for the behavior of their students in society? What responsibility should social studies educators, in particular, assume for producing citizens who will model society? How does this affect the agenda of future concerns and activities in social studies education? (Author/KSM)

Published
1973

19. International Analysis of Electronic Health Records of Children and Youth Hospitalized With COVID-19 Infection in 6 Countries

Author

Bourgeois, Florence, Gutiérrez-Sacristán, Alba, Keller, Mark, Liu, Molei, Hong, Chuan, Bonzel, Clara-Lea, Tan, Amelia, Aronow, Bruce, Boeker, Martin, Booth, John, Cruz Rojo, Jaime, Devkota, Batsal, García Barrio, Noelia, Gehlenborg, Nils, Geva, Alon, Hanauer, David, Hutch, Meghan, Issitt, Richard, Klann, Jeffrey, Luo, Yuan, Mandl, Kenneth, Mao, Chengsheng, Moal, Bertrand, Moshal, Karyn, Murphy, Shawn, Neuraz, Antoine, Ngiam, Kee Yuan, Omenn, Gilbert, Patel, Lav, Jiménez, Miguel Pedrera, Sebire, Neil, Balazote, Pablo Serrano, Serret-Larmande, Arnaud, South, Andrew, Spiridou, Anastasia, Taylor, Deanne, Tippmann, Patric, Visweswaran, Shyam, Weber, Griffin, Kohane, Isaac, Cai, Tianxi, Avillach, Paul, Cruz-Rojo, Jaime, García-Barrio, Noelia, Pedrera-Jiménez, Miguel, Serrano-Balazote, Pablo, Aaron, James, Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo, Angoulvant, François, Anthony, Li Llj, Atz, Andrew, Balshi, James, Beaulieu-Jones, Brett, Bell, Douglas, Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Blanco Martínez, Alvar, Bosari, Silvano, Bradford, Robert, Brat, Gabriel, Bréant, Stéphane, Brown, Nicholas, Bryant, William, Bucalo, Mauro, Burgun, Anita, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Krista, Chen, Jin, Chiovato, Luca, Chiudinelli, Lorenzo, Cimino, James, Colicchio, Tiago, Cormont, Sylvie, Cossin, Sébastien, Craig, Jean, Cruz Bermúdez, Juan Luis, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Dubiel, Julien, Duvall, Scott, Esteve, Loic, Fan, Shirley, Follett, Robert, Gaiolla, Paula Sa, Ganslandt, Thomas, Garmire, Lana, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Haverkamp, Christian, He, Bing, Henderson, Darren, Hilka, Martin, Holmes, John, Horki, Petar, Huling, Kenneth, Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Kirchoff, Katie, Krantz, Ian, Kraska, Detlef, Krishnamurthy, Ashok, L'Yi, Sehi, Le, Trang, Leblanc, Judith, Leite, Andressa Rr, Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Loh, Ne Hooi Will, Lynch, Kristine, Mahmood, Sadiqa, Maidlow, Sarah, Malovini, Alberto, Maram, Anupama, Martel, Patricia, Masino, Aaron, Matheny, Michael, Maulhardt, Thomas, Mazzitelli, Maria, Mcduffie, Michael, Mensch, Arthur, Milano, Marianna, Minicucci, Marcos, Moore, Jason, Moraleda, Cinta, Morris, Jeffrey, Morris, Michele, Mousavi, Sajad, Mowery, Danielle, Murad, Douglas, Naughton, Thomas, Norman, James, Obeid, Jihad, Okoshi, Marina, Olson, Karen, Orlova, Nina, Ostasiewski, Brian, Palmer, Nathan, Paris, Nicolas, Pfaff, Emily, Pillion, Danielle, Prokosch, Hans, Prudente, Robson, Quirós González, Víctor, Ramoni, Rachel, Raskin, Maryna, Rieg, Siegbert, Roig Domínguez, Gustavo, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Samayamuthu, Malarkodi, Sandrin, Arnaud, Santos, Janaina Cc, Savino, Maria, Schriver, Emily, Schuettler, Juergen, Scudeller, Luigia, Serre, Patricia, Silvio, Domenick, Sliz, Piotr, Son, Jiyeon, Sonday, Charles, Tan, Bryce Wq, Tan, Byorn Wl, Tanni, Suzana, Terriza Torres, Ana, Tibollo, Valentina, Torti, Carlo, Trecarichi, Enrico, Tseng, Yi-Ju, Vallejos, Andrew, Varoquaux, Gael, Vie, Jill-Jênn, Vitacca, Michele, Wagholikar, Kavishwar, Waitman, Lemuel, Wassermann, Demian, William, Yuan, Xia, Zongqi, Yehya, Nadir, Zambelli, Alberto, Zhang, Harrison, Zucco, Chiara, Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), Dr Bourgeois was funded by a grant from the Burroughs Wellcome Fund and supported by the Harvard-MIT Center for Regulatory Science. Mr Keller was funded by grant 5T32HG002295-18 from the National Human Genome Research Institute (NHGRI). Dr Aronow was funded by grant U24 HL148865 from the National Heart, Lung, and Blood Institute (NHLBI). Ms García Barrio was supported by grant PI18/00981 from the Carlos III Health Institute. Dr Gehlenborg was funded by grant T15 LM007092 from the NIH National Library of Medicine. Dr Geva was funded by grant K12 HD047349 from the NIH and Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr Hanauer was funded by grant UL1TR002240 from the National Center for Advancing Translational Sciences (NCATS). Drs Klann and Murphy were funded by grant 5UL1TR001857-05 from the NCATS and grant 5R01HG009174-04 from the NHGRI. Dr Luo was funded by grant R01LM013337 from the NLM. Mr Patel was funded by grant UL1TR002366 from the NCATS. Dr Gutiérrez-Sacristán was funded by grants K23HL148394 and L40HL148910 from the NIH NHLBI and grant UL1TR001420 from the NIH NCATS. Dr Visweswaran was funded by grant R01LM012095 from the NLM and grant UL1TR001857 from the NCATS. Dr Weber was supported by grants UL1TR002541 and UL1TR000005 from the NIH-NCATS, and grant R01LM013345 from the NLM., CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), and Université Paris Cité (UPC)

Subjects
medicine.medical_specialty, MESH: Pandemics, education, Health Informatics, MESH: Global Health, MESH: Hospitalization, Procalcitonin, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, MESH: Child, Epidemiology, medicine, Infection control, MESH: COVID-19, MESH: SARS-CoV-2, 030212 general & internal medicine, health care economics and organizations, MESH: Electronic Health Records, Original Investigation, MESH: Adolescent, Disease surveillance, MESH: Humans, business.industry, Research, MESH: Infant, Newborn, MESH: Child, Preschool, Retrospective cohort study, MESH: Retrospective Studies, General Medicine, medicine.disease, MESH: Infant, MESH: Male, 3. Good health, Online Only, Respiratory failure, Viral pneumonia, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

This cohort study aims to describe international hospitalization trends and key epidemiological and clinical features of children and youth with COVID-19., Key Points Question What are international trends in hospitalizations for children and youth with SARS-CoV-2, and what are the epidemiological and clinical features of these patients? Findings This cohort study of 671 children and youth found discrete surges in hospitalizations with variable trends and timing across countries. Common complications included cardiac arrhythmias and viral pneumonia, and laboratory findings included elevations in markers of inflammation and abnormalities of coagulation; few children and youth were treated with medications directed specifically at SARS-CoV-2. Meaning These findings suggest large-scale informatics-based approaches used to incorporate electronic health record data across health care systems can provide an efficient source of information to monitor disease activity and define epidemiological and clinical features of pediatric patients hospitalized with SARS-CoV-2 infections., Importance Additional sources of pediatric epidemiological and clinical data are needed to efficiently study COVID-19 in children and youth and inform infection prevention and clinical treatment of pediatric patients. Objective To describe international hospitalization trends and key epidemiological and clinical features of children and youth with COVID-19. Design, Setting, and Participants This retrospective cohort study included pediatric patients hospitalized between February 2 and October 10, 2020. Patient-level electronic health record (EHR) data were collected across 27 hospitals in France, Germany, Spain, Singapore, the UK, and the US. Patients younger than 21 years who tested positive for COVID-19 and were hospitalized at an institution participating in the Consortium for Clinical Characterization of COVID-19 by EHR were included in the study. Main Outcomes and Measures Patient characteristics, clinical features, and medication use. Results There were 347 males (52%; 95% CI, 48.5-55.3) and 324 females (48%; 95% CI, 44.4-51.3) in this study’s cohort. There was a bimodal age distribution, with the greatest proportion of patients in the 0- to 2-year (199 patients [30%]) and 12- to 17-year (170 patients [25%]) age range. Trends in hospitalizations for 671 children and youth found discrete surges with variable timing across 6 countries. Data from this cohort mirrored national-level pediatric hospitalization trends for most countries with available data, with peaks in hospitalizations during the initial spring surge occurring within 23 days in the national-level and 4CE data. A total of 27 364 laboratory values for 16 laboratory tests were analyzed, with mean values indicating elevations in markers of inflammation (C-reactive protein, 83 mg/L; 95% CI, 53-112 mg/L; ferritin, 417 ng/mL; 95% CI, 228-607 ng/mL; and procalcitonin, 1.45 ng/mL; 95% CI, 0.13-2.77 ng/mL). Abnormalities in coagulation were also evident (D-dimer, 0.78 ug/mL; 95% CI, 0.35-1.21 ug/mL; and fibrinogen, 477 mg/dL; 95% CI, 385-569 mg/dL). Cardiac troponin, when checked (n = 59), was elevated (0.032 ng/mL; 95% CI, 0.000-0.080 ng/mL). Common complications included cardiac arrhythmias (15.0%; 95% CI, 8.1%-21.7%), viral pneumonia (13.3%; 95% CI, 6.5%-20.1%), and respiratory failure (10.5%; 95% CI, 5.8%-15.3%). Few children were treated with COVID-19–directed medications. Conclusions and Relevance This study of EHRs of children and youth hospitalized for COVID-19 in 6 countries demonstrated variability in hospitalization trends across countries and identified common complications and laboratory abnormalities in children and youth with COVID-19 infection. Large-scale informatics-based approaches to integrate and analyze data across health care systems complement methods of disease surveillance and advance understanding of epidemiological and clinical features associated with COVID-19 in children and youth.

Published
2021
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22. Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2

Author

Hong, Chuan, Zhang, Harrison, L'Yi, Sehi, Weber, Griffin, Avillach, Paul, Tan, Bryce, Gutiérrez-Sacristán, Alba, Bonzel, Clara-Lea, Palmer, Nathan, Malovini, Alberto, Tibollo, Valentina, Luo, Yuan, Hutch, Meghan, Liu, Molei, Bourgeois, Florence, Bellazzi, Riccardo, Chiovato, Luca, Sanz Vidorreta, Fernando, Le, Trang, Wang, Xuan, Yuan, William, Neuraz, Antoine, Benoit, Vincent, Moal, Bertrand, Morris, Michele, Hanauer, David, Maidlow, Sarah, Wagholikar, Kavishwar, Murphy, Shawn, Estiri, Hossein, Makoudjou, Adeline, Tippmann, Patric, Klann, Jeffery, Follett, Robert, Gehlenborg, Nils, Omenn, Gilbert, Xia, Zongqi, Dagliati, Arianna, Visweswaran, Shyam, Patel, Lav, Mowery, Danielle, Schriver, Emily, Samayamuthu, Malarkodi Jebathilagam, Kavuluru, Ramakanth, Lozano-Zahonero, Sara, Zöller, Daniela, Tan, Amelia, Tan, Byorn, Ngiam, Kee Yuan, Holmes, John, Schubert, Petra, Cho, Kelly, Ho, Yuk-Lam, Beaulieu-Jones, Brett, Pedrera-Jiménez, Miguel, García-Barrio, Noelia, Serrano-Balazote, Pablo, Kohane, Isaac, South, Andrew, Brat, Gabriel, Cai, T, Harvard Medical School [Boston] (HMS), Brigham & Women’s Hospital [Boston] (BWH), Columbia University [New York], National University Hospital [Singapore] (NUH), Istituti Clinici Scientifici Maugeri [Pavia] (IRCCS Pavia - ICS Maugeri), Northwestern University [Chicago, Ill. USA], Università degli Studi di Pavia = University of Pavia (UNIPV), Laboratoire Magmas et Volcans (LMV), Institut national des sciences de l'Univers (INSU - CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut de Recherche pour le Développement et la société-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Institut national des sciences de l'Univers (INSU - CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), University of Science and Technology of China [Hefei] (USTC), Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Northwestern University [Evanston], Harvard T.H. Chan School of Public Health, David Geffen School of Medicine [Los Angeles], University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), University of Pennsylvania, École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université de Bordeaux (UB), University of Pittsburgh (PITT), Pennsylvania Commonwealth System of Higher Education (PCSHE), University of Michigan Medical School [Ann Arbor], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, University of Michigan System, Massachusetts General Hospital [Boston], University of Freiburg [Freiburg], University of Kansas [Kansas City], Hospital of the University of Pennsylvania (HUP), Perelman School of Medicine, University of Pennsylvania-University of Pennsylvania, University of Kentucky (UK), VA Boston Healthcare System, Hospital Universitario 12 de Octubre [Madrid], and Wake Forest University

Subjects
Hospitalization, SARS-CoV-2, COVID-19, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Pandemics, Retrospective Studies
Abstract

ObjectiveTo assess changes in international mortality rates and laboratory recovery rates during hospitalisation for patients hospitalised with SARS-CoV-2 between the first wave (1 March to 30 June 2020) and the second wave (1 July 2020 to 31 January 2021) of the COVID-19 pandemic.Design, setting and participantsThis is a retrospective cohort study of 83 178 hospitalised patients admitted between 7 days before or 14 days after PCR-confirmed SARS-CoV-2 infection within the Consortium for Clinical Characterization of COVID-19 by Electronic Health Record, an international multihealthcare system collaborative of 288 hospitals in the USA and Europe. The laboratory recovery rates and mortality rates over time were compared between the two waves of the pandemic.Primary and secondary outcome measuresThe primary outcome was all-cause mortality rate within 28 days after hospitalisation stratified by predicted low, medium and high mortality risk at baseline. The secondary outcome was the average rate of change in laboratory values during the first week of hospitalisation.ResultsBaseline Charlson Comorbidity Index and laboratory values at admission were not significantly different between the first and second waves. The improvement in laboratory values over time was faster in the second wave compared with the first. The average C reactive protein rate of change was –4.72 mg/dL vs –4.14 mg/dL per day (p=0.05). The mortality rates within each risk category significantly decreased over time, with the most substantial decrease in the high-risk group (47.1% in March–April 2020 vs 30.8% in November 2020 to January 2021, pConclusionsAdmission profiles of patients hospitalised with SARS-CoV-2 infection did not differ greatly between the first and second waves of the pandemic, but there were notable differences in laboratory improvement rates during hospitalisation. Mortality risks among patients with similar risk profiles decreased over the course of the pandemic. The improvement in laboratory values and mortality risk was consistent across multiple countries.

Published
2022
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23. Tiny Bodies, Big Needs: Prospective Biobanking of Neonatal Clinical Remnant Samples

Author

Schleif, William, primary, Hamblin, Frances, additional, Everett, Allen D., additional, Graham, Ernest M., additional, Cross, Jennifer, additional, Fernald, Christy, additional, Follett, Robert, additional, Lopes, Bryan, additional, Martinez, Denise, additional, Monforte, Hector, additional, Ross-Wilkinson, Jennifer, additional, Sellers, Austin, additional, and Brooks, Sandra, additional

Published
2021
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24. Development of a Coronavirus Disease 2019 (COVID-19) Application Ontology for the Accrual to Clinical Trials (ACT) network

Author

Visweswaran, Shyam, primary, Samayamuthu, Malarkodi J, additional, Morris, Michele, additional, Weber, Griffin M, additional, MacFadden, Douglas, additional, Trevvett, Philip, additional, Klann, Jeffrey G, additional, Gainer, Vivian S, additional, Benoit, Barbara, additional, Murphy, Shawn N, additional, Patel, Lav, additional, Mirkovic, Nebojsa, additional, Borovskiy, Yuliya, additional, Johnson, Robert D, additional, Wyatt, Matthew C, additional, Wang, Amy Y, additional, Follett, Robert W, additional, Chau, Ngan, additional, Zhu, Wenhong, additional, Abajian, Mark, additional, Chuang, Amy, additional, Bahroos, Neil, additional, Reeder, Phillip, additional, Xie, Donglu, additional, Cai, Jennifer, additional, Sendro, Elaina R, additional, Toto, Robert D, additional, Firestein, Gary S, additional, Nadler, Lee M, additional, and Reis, Steven E, additional

Published
2021
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25. Impact of a 'chart closure' hard stop alert on prescribing for elevated blood pressures among patients with diabetes quasi-experimental study.

Author

Ramirez, Magaly., Chen, Kimberly, Follett, Robert W, Mangione, Carol M, Moreno, Gerardo, Bell, Douglas S, Ramirez, Magaly., Chen, Kimberly, Follett, Robert W, Mangione, Carol M, Moreno, Gerardo, and Bell, Douglas S

Abstract

University of California at Los Angeles Health implemented a Best Practice Advisory (BPA) alert for the initiation of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) for individuals with diabetes. The BPA alert was configured with a "chart closure" hard stop, which demanded a response before closing the chart.ObjectiveThe aim of the study was to evaluate whether the implementation of the BPA was associated with changes in ACEI and ARB prescribing during primary care encounters for patients with diabetes.MethodsWe defined ACEI and ARB prescribing opportunities as primary care encounters in which the patient had a diabetes diagnosis, elevated blood pressure in recent encounters, no active ACEI or ARB prescription, and no contraindications. We used a multivariate logistic regression model to compare the change in the probability of an ACEI or ARB prescription during opportunity encounters before and after BPA implementation in primary care sites that did (n=30) and did not (n=31) implement the BPA. In an additional subgroup analysis, we compared ACEI and ARB prescribing in BPA implementation sites that had also implemented a pharmacist-led medication management program.ResultsWe identified a total of 2438 opportunity encounters across 61 primary care sites. The predicted probability of an ACEI or ARB prescription increased significantly from 11.46% to 22.17% during opportunity encounters in BPA implementation sites after BPA implementation. However, in the subgroup analysis, we only observed a significant improvement in ACEI and ARB prescribing in BPA implementation sites that had also implemented the pharmacist-led program. Overall, the change in the predicted probability of an ACEI or ARB prescription from before to after BPA implementation was significantly greater in BPA implementation sites compared with nonimplementation sites (difference-in-differences of 11.82; P<.001).ConclusionsA BPA with a "chart closure"

Published
2020

26. Development of a COVID-19 Application Ontology for the ACT Network

Author

Visweswaran, Shyam, primary, Samayamuthu, Malarkodi J., additional, Morris, Michele, additional, Weber, Griffin M., additional, MacFadden, Douglas, additional, Trevvett, Philip, additional, Klann, Jeffrey G., additional, Gainer, Vivian, additional, Benoit, Barbara, additional, Murphy, Shawn N., additional, Patel, Lav, additional, Mirkovic, Nebojsa, additional, Borovskiy, Yuliya, additional, Johnson, Robert D., additional, Wyatt, Matthew C., additional, Wang, Amy Y., additional, Follett, Robert W., additional, Chau, Ngan, additional, Zhu, Wenhong, additional, Abajian, Mark, additional, Chuang, Amy, additional, Bahroos, Neil, additional, Reeder, Phillip, additional, Xie, Donglu, additional, Cai, Jennifer, additional, Sendro, Elaina R., additional, Toto, Robert D., additional, Firestein, Gary S., additional, Nadler, Lee M., additional, and Reis, Steven E., additional

Published
2021
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27. International Changes in COVID-19 Clinical Trajectories Across 315 Hospitals and 6 Countries: Retrospective Cohort Study

Author

Weber, Griffin M, Zhang, Harrison G, L'Yi, Sehi, Bonzel, Clara-Lea, Hong, Chuan, Avillach, Paul, Gutiérrez-Sacristán, Alba, Palmer, Nathan P, Tan, Amelia Li Min, Wang, Xuan, Yuan, William, Gehlenborg, Nils, Alloni, Anna, Amendola, Danilo F, Bellasi, Antonio, Bellazzi, Riccardo, Beraghi, Michele, Bucalo, Mauro, Chiovato, Luca, Cho, Kelly, Dagliati, Arianna, Estiri, Hossein, Follett, Robert W, García Barrio, Noelia, Hanauer, David A, Henderson, Darren W, Ho, Yuk-Lam, Holmes, John H, Hutch, Meghan R, Kavuluru, Ramakanth, Kirchoff, Katie, Klann, Jeffrey G, Krishnamurthy, Ashok K, Le, Trang T, Liu, Molei, Loh, Ne Hooi Will, Lozano-Zahonero, Sara, Luo, Yuan, Maidlow, Sarah, Makoudjou, Adeline, Malovini, Alberto, Martins, Marcelo Roberto, Moal, Bertrand, Morris, Michele, Mowery, Danielle L, Murphy, Shawn N, Neuraz, Antoine, Ngiam, Kee Yuan, Okoshi, Marina P, Omenn, Gilbert S, Patel, Lav P, Pedrera Jiménez, Miguel, Prudente, Robson A, Samayamuthu, Malarkodi Jebathilagam, Sanz Vidorreta, Fernando J, Schriver, Emily R, Schubert, Petra, Serrano Balazote, Pablo, Tan, Byorn WL, Tanni, Suzana E, Tibollo, Valentina, Visweswaran, Shyam, Wagholikar, Kavishwar B, Xia, Zongqi, Zöller, Daniela, Kohane, Isaac S, Cai, Tianxi, South, Andrew M, Brat, Gabriel A, Harvard Medical School, BIOMERIS (BIOMedical Research Informatics Solutions), Universidade Estadual Paulista (UNESP), Ente Ospedaliero Cantonale, University of Pavia, Azienda Socio-Sanitaria Territoriale di Pavia, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Veterans Affairs Boston Healthcare System, Massachusetts General Hospital, Los Angeles, Hospital Universitario 12 de Octubre, University of Michigan Medical School, University of Kentucky, University of Pennsylvania Perelman School of Medicine, Northwestern University, Medical University of South Carolina, University of North Carolina at Chapel Hill, Harvard T.H. Chan School of Public Health, National University Health System, University of Freiburg, University of Michigan, Bordeaux University Hospital, University of Pittsburgh, University of Paris, University of Kansas Medical Center, University of Pennsylvania Health System, Wake Forest School of Medicine, Service d'informatique médicale et biostatistiques [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Université Paris Cité - UFR Médecine Paris Centre [Santé] (UPC Médecine Paris Centre), Université Paris Cité (UPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), and Université Paris Cité (UPCité)

Subjects
Retrospective cohort study, MESH: Pandemics, medicine.medical_specialty, severe COVID-19, Health Informatics, MESH: Hospitalization, 030204 cardiovascular system & hematology, Lower risk, Procalcitonin, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, Health care, medicine, MESH: COVID-19, Electronic health records, MESH: SARS-CoV-2, 030212 general & internal medicine, Severe COVID-19, retrospective cohort study, MESH: Aged, laboratory trajectory, Original Paper, MESH: Middle Aged, MESH: Humans, SARS-CoV-2, business.industry, Laboratory trajectory, COVID-19, International health, MESH: Adult, MESH: Retrospective Studies, Federated study, MESH: Hospitals, Random effects model, MESH: Male, 3. Good health, meta-analysis, Meta-analysis, electronic health records, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, federated study
Abstract

Made available in DSpace on 2022-04-29T08:35:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 National Human Genome Research Institute National Center for Advancing Translational Sciences National Heart, Lung, and Blood Institute National Institutes of Health U.S. National Library of Medicine National Institute of Neurological Disorders and Stroke Canadian Thoracic Society Background: Many countries have experienced 2 predominant waves of COVID-19–related hospitalizations. Comparing the clinical trajectories of patients hospitalized in separate waves of the pandemic enables further understanding of the evolving epidemiology, pathophysiology, and health care dynamics of the COVID-19 pandemic. Objective: In this retrospective cohort study, we analyzed electronic health record (EHR) data from patients with SARS-CoV-2 infections hospitalized in participating health care systems representing 315 hospitals across 6 countries. We compared hospitalization rates, severe COVID-19 risk, and mean laboratory values between patients hospitalized during the first and second waves of the pandemic. Methods: Using a federated approach, each participating health care system extracted patient-level clinical data on their first and second wave cohorts and submitted aggregated data to the central site. Data quality control steps were adopted at the central site to correct for implausible values and harmonize units. Statistical analyses were performed by computing individual health care system effect sizes and synthesizing these using random effect meta-analyses to account for heterogeneity. We focused the laboratory analysis on C-reactive protein (CRP), ferritin, fibrinogen, procalcitonin, D-dimer, and creatinine based on their reported associations with severe COVID-19. Results: Data were available for 79,613 patients, of which 32,467 were hospitalized in the first wave and 47,146 in the second wave. The prevalence of male patients and patients aged 50 to 69 years decreased significantly between the first and second waves. Patients hospitalized in the second wave had a 9.9% reduction in the risk of severe COVID-19 compared to patients hospitalized in the first wave (95% CI 8.5%-11.3%). Demographic subgroup analyses indicated that patients aged 26 to 49 years and 50 to 69 years; male and female patients; and black patients had significantly lower risk for severe disease in the second wave than in the first wave. At admission, the mean values of CRP were significantly lower in the second wave than in the first wave. On the seventh hospital day, the mean values of CRP, ferritin, fibrinogen, and procalcitonin were significantly lower in the second wave than in the first wave. In general, countries exhibited variable changes in laboratory testing rates from the first to the second wave. At admission, there was a significantly higher testing rate for D-dimer in France, Germany, and Spain. Conclusions: Patients hospitalized in the second wave were at significantly lower risk for severe COVID-19. This corresponded to mean laboratory values in the second wave that were more likely to be in typical physiological ranges on the seventh hospital day compared to the first wave. Our federated approach demonstrated the feasibility and power of harmonizing heterogeneous EHR data from multiple international health care systems to rapidly conduct large-scale studies to characterize how COVID-19 clinical trajectories evolve. Department of Biomedical Informatics Harvard Medical School BIOMERIS (BIOMedical Research Informatics Solutions) Clinical Research Unit Botucatu Medical School São Paulo State University Division of Nephrology Department of Medicine Ente Ospedaliero Cantonale Department of Electrical Computer and Biomedical Engineering University of Pavia Information Technology Department Azienda Socio-Sanitaria Territoriale di Pavia Unit of Internal Medicine and Endocrinology Istituti Clinici Scientifici Maugeri SpA SB IRCCS Massachusetts Veterans Epidemiology Research and Information Center Veterans Affairs Boston Healthcare System Department of Medicine Massachusetts General Hospital Department of Medicine David Geffen School of Medicine University of California Los Angeles Health Informatics Hospital Universitario 12 de Octubre Department of Learning Health Sciences University of Michigan Medical School Department of Biomedical Informatics University of Kentucky Department of Biostatistics Epidemiology and Informatics University of Pennsylvania Perelman School of Medicine Institute for Biomedical Informatics University of Pennsylvania Perelman School of Medicine Department of Preventive Medicine Northwestern University Institute for Biomedical Informatics University of Kentucky Medical University of South Carolina Department of Computer Science Renaissance Computing Institute University of North Carolina at Chapel Hill Department of Biostatistics Harvard T.H. Chan School of Public Health Department of Anaesthesia National University Health System Institute of Medical Biometry and Statistics Faculty of Medicine and Medical Center University of Freiburg Michigan Institute for Clinical & Health Research Informatics University of Michigan Laboratory of Informatics and Systems Engineering for Clinical Research Istituti Clinici Scientifici Maugeri SpA SB IRCCS Clinical Hospital of Botucatu Medical School São Paulo State University Informatique et Archivistique Médicales Unit Bordeaux University Hospital Department of Biomedical Informatics University of Pittsburgh Department of Neurology Massachusetts General Hospital Department of Biomedical Informatics Hôpital Necker-Enfants Malade Assistance Publique Hôpitaux de Paris University of Paris Department of Biomedical Informatics Institute for Digital Medicine National University Health System Internal Medicine Department Botucatu Medical School São Paulo State University Department of Computational Medicine & Bioinformatics Internal Medicine Human Genetics and Public Health University of Michigan Division of Medical Informatics Department of Internal Medicine University of Kansas Medical Center Data Analytics Center University of Pennsylvania Health System Department of Medicine National University Health System Department of Neurology University of Pittsburgh Section of Nephrology Department of Pediatrics Brenner Children's Hospital Wake Forest School of Medicine Clinical Research Unit Botucatu Medical School São Paulo State University Clinical Hospital of Botucatu Medical School São Paulo State University Internal Medicine Department Botucatu Medical School São Paulo State University National Human Genome Research Institute: 3U01HG008685-05S2 National Human Genome Research Institute: 5R01HG009174-04 National Center for Advancing Translational Sciences: 5UL1TR001857-05 National Heart, Lung, and Blood Institute: K23HL148394 National Heart, Lung, and Blood Institute: L40HL148910 National Institutes of Health: P30ES017885 U.S. National Library of Medicine: R01LM012095 U.S. National Library of Medicine: R01LM013345 National Institute of Neurological Disorders and Stroke: R01NS098023 U.S. National Library of Medicine: T15LM007092 National Institutes of Health: U24CA210967 National Center for Advancing Translational Sciences: UL1TR000005 National Center for Advancing Translational Sciences: UL1TR001420 National Center for Advancing Translational Sciences: UL1TR001450 National Center for Advancing Translational Sciences: UL1TR001857 National Center for Advancing Translational Sciences: UL1TR001878 National Center for Advancing Translational Sciences: UL1TR001881 Canadian Thoracic Society: UL1TR001998 National Center for Advancing Translational Sciences: UL1TR002240 Canadian Thoracic Society: UL1TR002366 National Center for Advancing Translational Sciences: UL1TR002541

Published
2021
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28. Preoperative Trapped Lung Is Associated With Increased Mortality After Orthotopic Liver Transplantation

Author

Melamed, Kathryn H., primary, Dai, David, additional, Cuk, Natasha, additional, Markovic, Daniela, additional, Follett, Robert, additional, Wang, Tisha, additional, Lopez, Roxana Cortes, additional, Shirali, Aditya S., additional, Yanagawa, Jane, additional, Busuttil, Ronald, additional, Kaldas, Fady, additional, and Barjaktarevic, Igor, additional

Published
2020
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30. Impact of a 'chart closure' hard stop alert on prescribing for elevated blood pressures among patients with diabetes quasi-experimental study (preprint).

Author

Ramirez, Magaly., Chen, Kimberly, Follett, Robert W, Mangione, Carol M, Moreno, Gerardo, Bell, Douglas S, Ramirez, Magaly., Chen, Kimberly, Follett, Robert W, Mangione, Carol M, Moreno, Gerardo, and Bell, Douglas S

Abstract

BACKGROUND University of California at Los Angeles Health implemented a Best Practice Advisory (BPA) alert for the initiation of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) for individuals with diabetes. The BPA alert was configured with a "chart closure" hard stop, which demanded a response before closing the chart. OBJECTIVE The aim of the study was to evaluate whether the implementation of the BPA was associated with changes in ACEI and ARB prescribing during primary care encounters for patients with diabetes. METHODS We defined ACEI and ARB prescribing opportunities as primary care encounters in which the patient had a diabetes diagnosis, elevated blood pressure in recent encounters, no active ACEI or ARB prescription, and no contraindications. We used a multivariate logistic regression model to compare the change in the probability of an ACEI or ARB prescription during opportunity encounters before and after BPA implementation in primary care sites that did (n=30) and did not (n=31) implement the BPA. In an additional subgroup analysis, we compared ACEI and ARB prescribing in BPA implementation sites that had also implemented a pharmacist-led medication management program. RESULTS We identified a total of 2438 opportunity encounters across 61 primary care sites. The predicted probability of an ACEI or ARB prescription increased significantly from 11.46% to 22.17% during opportunity encounters in BPA implementation sites after BPA implementation. However, in the subgroup analysis, we only observed a significant improvement in ACEI and ARB prescribing in BPA implementation sites that had also implemented the pharmacist-led program. Overall, the change in the predicted probability of an ACEI or ARB prescription from before to after BPA implementation was significantly greater in BPA implementation sites compared with nonimplementation sites (difference-in-differences of 11.82; P<.001). CONCLUSIONS A BPA with a "chart

Published
2019

33. Preoperative Trapped Lung Is Associated With Increased Mortality After Orthotopic Liver Transplantation.

Author

Melamed, Kathryn H., Dai, David, Cuk, Natasha, Markovic, Daniela, Follett, Robert, Wang, Tisha, Lopez, Roxana Cortes, Shirali, Aditya S., Yanagawa, Jane, Busuttil, Ronald, Kaldas, Fady, and Barjaktarevic, Igor

Subjects
SURGICAL complication risk factors, MORTALITY risk factors, PLEURAL effusions, CONFIDENCE intervals, PREOPERATIVE period, LUNGS, LOG-rank test, RETROSPECTIVE studies, MANN Whitney U Test, FISHER exact test, DESCRIPTIVE statistics, LIVER transplantation, ATELECTASIS, DATA analysis software, LIVER failure, PNEUMOTHORAX, LONGITUDINAL method, DISEASE complications
Abstract

Introduction: Trapped lung, characterized by atelectatic lung unable to reexpand and fill the thoracic cavity due to a restricting fibrous visceral pleural peel, is occasionally seen in patients with end-stage liver disease complicated by hepatic hydrothorax. Limited data suggest that trapped lung prior to orthotopic liver transplantation may be associated with poor outcomes. Research Question: What is the clinical significance of trapped lung in patients receiving orthotopic liver transplantation? Design: We performed a retrospective analysis of patients who underwent liver transplantation over an 8-year period. Baseline clinical characteristics and postoperative outcomes of adult patients with trapped lung were analyzed and compared to the overall cohort of liver transplant recipients and controls matched 3:1 based on age, sex, Model for End-Stage Liver Disease (MELD) score, and presence of pleural effusion. Results: Of the 1193 patients who underwent liver transplantation, we identified 20 patients (1.68%) with trapped lung. The probability of 1 and 2-year survival were 75.0% and 57.1%, compared to 85.6% and 80.4% (p = 0.02) in all liver transplant recipients and 87.9% and 81.1% (p = 0.03) in matched controls respectively. Patients with trapped lung had a longer hospital length of stay compared to the total liver transplant population (geometric mean 54.9 ± 8.4 vs. 27.2 ± 0.7 days, p ≤ 0.001), when adjusted for age and MELD score. Discussion: Patients with trapped prior to orthotopic liver transplantation have increased probability of mortality as well as increased health care utilization. This is a small retrospective analysis, and further prospective investigation is warranted. [ABSTRACT FROM AUTHOR]

Published
2021
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34. Power plant start-up demands productive methods and practices

Author

Follett, Robert E.

Subjects
Power plants -- Planning, Electric utilities -- Planning, Electric power-plants -- Planning, Business, Engineering and manufacturing industries, Petroleum, energy and mining industries, Company business planning, Planning
Abstract

Power plant start-up, especially of cogeneration plants, demands good planning and a well organized, experienced start-up group. Guidelines will help During the early stages of engineering a power plant, it [...]

Published
1993

37. Plant Start‐Up of an Atmospheric Fluidized Bed Boiler Retrofit

Author

Follett, Robert E. and Larva, W. John

Abstract

Start‐up activities at the Black Dog 130 MWe atmospheric fluidized bed combustor (AFBC) conversion began in February 1986 and ran concurrent with the construction schedule through June 1986. During this period, the boiler casing was air tested, and the water/steam circuitry was chemically cleaned. Forty‐six steam blows were made from drum pressures of 56.2 kg/cm2 (800 psig) to clean the boiler. The first fluidized‐bed coal fires were started on June 26, 1986, with the turbine on line and a maximum electrical power output of 45 MWe net. Gross power output as high as 95 MWe was achieved. Early in the Black Dog Unit 2 project, it was determined that only a bubbling fluidized bed combustor could be economically retrofit to the unit. Despite the limitations imposed by the project requirement to build a retrofit unit and not a completely new fluidized bed combustor (FBC), the Black Dog 2 retrofit provides operating flexibility that would be difficult to obtain with other designs. The paper describes what special design features make the operating flexibility possible and evaluate the economics of the design due to the process efficiency penalty when burning a hard Eastern coal.

Published
1988

40. Development of a COVID-19 Application Ontology for the ACT Network.

Author

Visweswaran S, Samayamuthu MJ, Morris M, Weber GM, MacFadden D, Trevvett P, Klann JG, Gainer V, Benoit B, Murphy SN, Patel L, Mirkovic N, Borovskiy Y, Johnson RD, Wyatt MC, Wang AY, Follett RW, Chau N, Zhu W, Abajian M, Chuang A, Bahroos N, Reeder P, Xie D, Cai J, Sendro ER, Toto RD, Firestein GS, Nadler LM, and Reis SE

Abstract

Clinical data networks that leverage large volumes of data in electronic health records (EHRs) are significant resources for research on coronavirus disease 2019 (COVID-19). Data harmonization is a key challenge in seamless use of multisite EHRs for COVID-19 research. We developed a COVID-19 application ontology in the national Accrual to Clinical Trials (ACT) network that enables harmonization of data elements that that are critical to COVID-19 research. The ontology contains over 50,000 concepts in the domains of diagnosis, procedures, medications, and laboratory tests. In particular, it has computational phenotypes to characterize the course of illness and outcomes, derived terms, and harmonized value sets for SARS-CoV-2 laboratory tests. The ontology was deployed and validated on the ACT COVID-19 network that consists of nine academic health centers with data on 14.5M patients. This ontology, which is freely available to the entire research community on GitHub at https://github.com/shyamvis/ACT-COVID-Ontology, will be useful for harmonizing EHRs for COVID-19 research beyond the ACT network.

Published
2021
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41. International Comparisons of Harmonized Laboratory Value Trajectories to Predict Severe COVID-19: Leveraging the 4CE Collaborative Across 342 Hospitals and 6 Countries: A Retrospective Cohort Study.

Author

Weber GM, Hong C, Palmer NP, Avillach P, Murphy SN, Gutiérrez-Sacristán A, Xia Z, Serret-Larmande A, Neuraz A, Omenn GS, Visweswaran S, Klann JG, South AM, Loh NHW, Cannataro M, Beaulieu-Jones BK, Bellazzi R, Agapito G, Alessiani M, Aronow BJ, Bell DS, Bellasi A, Benoit V, Beraghi M, Boeker M, Booth J, Bosari S, Bourgeois FT, Brown NW, Bucalo M, Chiovato L, Chiudinelli L, Dagliati A, Devkota B, DuVall SL, Follett RW, Ganslandt T, García Barrio N, Gradinger T, Griffier R, Hanauer DA, Holmes JH, Horki P, Huling KM, Issitt RW, Jouhet V, Keller MS, Kraska D, Liu M, Luo Y, Lynch KE, Malovini A, Mandl KD, Mao C, Maram A, Matheny ME, Maulhardt T, Mazzitelli M, Milano M, Moore JH, Morris JS, Morris M, Mowery DL, Naughton TP, Ngiam KY, Norman JB, Patel LP, Pedrera Jimenez M, Ramoni RB, Schriver ER, Scudeller L, Sebire NJ, Serrano Balazote P, Spiridou A, Tan AL, Tan BW, Tibollo V, Torti C, Trecarichi EM, Vitacca M, Zambelli A, Zucco C, Kohane IS, Cai T, and Brat GA

Abstract

Objectives: To perform an international comparison of the trajectory of laboratory values among hospitalized patients with COVID-19 who develop severe disease and identify optimal timing of laboratory value collection to predict severity across hospitals and regions., Design: Retrospective cohort study., Setting: The Consortium for Clinical Characterization of COVID-19 by EHR (4CE), an international multi-site data-sharing collaborative of 342 hospitals in the US and in Europe., Participants: Patients hospitalized with COVID-19, admitted before or after PCR-confirmed result for SARS-CoV-2., Primary and Secondary Outcome Measures: Patients were categorized as "ever-severe" or "never-severe" using the validated 4CE severity criteria. Eighteen laboratory tests associated with poor COVID-19-related outcomes were evaluated for predictive accuracy by area under the curve (AUC), compared between the severity categories. Subgroup analysis was performed to validate a subset of laboratory values as predictive of severity against a published algorithm. A subset of laboratory values (CRP, albumin, LDH, neutrophil count, D-dimer, and procalcitonin) was compared between North American and European sites for severity prediction., Results: Of 36,447 patients with COVID-19, 19,953 (43.7%) were categorized as ever-severe. Most patients (78.7%) were 50 years of age or older and male (60.5%). Longitudinal trajectories of CRP, albumin, LDH, neutrophil count, D-dimer, and procalcitonin showed association with disease severity. Significant differences of laboratory values at admission were found between the two groups. With the exception of D-dimer, predictive discrimination of laboratory values did not improve after admission. Sub-group analysis using age, D-dimer, CRP, and lymphocyte count as predictive of severity at admission showed similar discrimination to a published algorithm (AUC=0.88 and 0.91, respectively). Both models deteriorated in predictive accuracy as the disease progressed. On average, no difference in severity prediction was found between North American and European sites., Conclusions: Laboratory test values at admission can be used to predict severity in patients with COVID-19. Prediction models show consistency across international sites highlighting the potential generalizability of these models., Competing Interests: COMPETING INTEREST STATEMENT There are no competing interests to report.

Published
2021
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