The application of clinical registries in ophthalmic trauma—the International Globe and Adnexal Trauma Epidemiology Study (IGATES)

2021 ◽  
Author(s):  
Sean Ming Sheng Ng ◽  
Rebecca Low ◽  
Annette K. Hoskin ◽  
Andres Rousselot ◽  
Dinesh Visva Gunasekeran ◽  
...  
Keyword(s):  
Epidemiology Study ◽  
Clinical Registries

Knowledge-Based Decision Support for Diagnosis and Therapy: On the Multiple Usability of Patient Data

1989 ◽  
Vol 28 (02) ◽  
pp. 69-77 ◽  
Author(s):  
R. Haux
Keyword(s):  
Expert Systems ◽  
Statistical Data ◽  
Patient Data ◽  
Attribute Selection ◽  
Patient Specific ◽  
Statistical Data Analysis ◽  
Inference Mechanism ◽  
Diagnosis And Therapy ◽  
Knowledge Based ◽  
Clinical Registries

Abstract:Expert systems in medicine are frequently restricted to assisting the physician to derive a patient-specific diagnosis and therapy proposal. In many cases, however, there is a clinical need to use these patient data for other purposes as well. The intention of this paper is to show how and to what extent patient data in expert systems can additionally be used to create clinical registries and for statistical data analysis. At first, the pitfalls of goal-oriented mechanisms for the multiple usability of data are shown by means of an example. Then a data acquisition and inference mechanism is proposed, which includes a procedure for controlling selection bias, the so-called knowledge-based attribute selection. The functional view and the architectural view of expert systems suitable for the multiple usability of patient data is outlined in general and then by means of an application example. Finally, the ideas presented are discussed and compared with related approaches.

scholarly journals Cancer incidence in the middle region of Libya: Data from the cancer epidemiology study in Misurata

2021 ◽  
Author(s):  
Anas Zarmouh ◽  
Abdulrahman Almalti ◽  
Ahmad Alzedam ◽  
Marwa Hamad ◽  
Hamad Elmughrabi ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
Cancer Epidemiology ◽  
Middle Region ◽  
Epidemiology Study

scholarly journals Influenza Vaccine Effectiveness and Waning Effect in Hospitalized Older Adults. Valencia Region, Spain, 2018/2019 Season

2021 ◽  
Vol 18 (3) ◽  
pp. 1129
Author(s):  
Ainara Mira-Iglesias ◽  
F. Xavier López-Labrador ◽  
Javier García-Rubio ◽  
Beatriz Mengual-Chuliá ◽  
Miguel Tortajada-Girbés ◽  
...  
Keyword(s):  
Older Adults ◽  
Influenza Vaccine ◽  
Influenza A ◽  
Vaccine Effectiveness ◽  
Surveillance Network ◽  
Adjuvanted Vaccine ◽  
Clinical Registries ◽  
Populations At Risk ◽  
Influenza A H1n1 ◽  
Hospitalized Older Adults

Influenza vaccination is annually recommended for specific populations at risk, such as older adults. We estimated the 2018/2019 influenza vaccine effectiveness (IVE) overall, by influenza subtype, type of vaccine, and by time elapsed since vaccination among subjects 65 years old or over in a multicenter prospective study in the Valencia Hospital Surveillance Network for the Study of Influenza and other Respiratory Viruses (VAHNSI, Spain). Information about potential confounders was obtained from clinical registries and/or by interviewing patients and vaccination details were only ascertained by registries. A test-negative design was performed in order to estimate IVE. As a result, IVE was estimated at 46% (95% confidence interval (CI): (16%, 66%)), 41% (95% CI: (−34%, 74%)), and 45% (95% CI: (7%, 67%)) against overall influenza, A(H1N1)pdm09 and A(H3N2), respectively. An intra-seasonal not relevant waning effect was detected. The IVE for the adjuvanted vaccine in ≥75 years old was 45% (2%, 69%) and for the non-adjuvanted vaccine in 65–74 years old was 59% (−16%, 86%). Thus, our data revealed moderate vaccine effectiveness against influenza A(H3N2) and not significant against A(H1N1)pdm09. Significant protection was conferred by the adjuvanted vaccine to patients ≥75 years old. Moreover, an intra-seasonal not relevant waning effect was detected, and a not significant IVE decreasing trend was observed over time.

scholarly journals High Incidence of Hand Injuries From Blocking in Elite Taekwondo Despite the Use of Protective Gear: A 5-Year Descriptive Epidemiology Study

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097399
Author(s):  
Markus Geßlein ◽  
Johannes Rüther ◽  
Michael Millrose ◽  
Hermann Josef Bail ◽  
Robin Martin ◽  
...  
Keyword(s):  
Injury Risk ◽  
Injury Incidence ◽  
Dominant Hand ◽  
Wrist Injuries ◽  
Descriptive Epidemiology ◽  
Epidemiology Study ◽  
Time Loss ◽  
Data Set ◽  
Injury Site ◽  
Protective Gear

Background: Hand and wrist injuries are a common but underestimated issue in taekwondo. Detailed data on injury risk, patterns, and mechanism are missing. Purpose: To evaluate (1) the fight time exposure-adjusted injury incidence rate (IIR) and clinical incidence and (2) injury site, type, sport-specific mechanism, and time loss in taekwondo. Study Design: Descriptive epidemiology study. Methods: Athletes from a single national Olympic taekwondo training center were investigated prospectively for hand and wrist injuries during training and competition over 5 years. The Orchard Sports Injury Classification System Version 10 was used to classify injury type, and analysis of the anatomic injury site was performed. The mechanism of injury was classified as due to either striking or blocking techniques. Results: From a total of 107 athletes, 79 athletes (73.8%) with a total exposure time of 8495 hours were included in the final data set. During the study period, 75 injuries of the hand and wrist region were recorded despite the athletes using protective hand gear. The IIR was 13.9 (95% CI, 10.5-17.5) and was significantly higher during competition. The clinical incidence as an indicator for risk of injury was 60.7% (95% CI, 50.9-70.5). Finger rays were the most affected location (68%), and fractures (43%) and joint ligament injuries (35%) were the most common type of injury. Significantly more injuries were found on the dominant hand side ( P < .001). Comparison of injury mechanisms demonstrated significantly more injuries at the finger rays deriving from blocking techniques ( P = .0104). The mean time loss for all hand and wrist injuries was 15.7 ± 13.5 days (range, 3-45 days) and was highest for distal radial fractures, with a mean of 39.7 ± 4.8 days (range, 32-45 days). Conclusion: There was a significantly higher IIR for acute hand and wrist injuries in elite taekwondo athletes during competition, which resulted in considerable time loss, especially when fractures or dislocations occurred. Significantly more injuries to the finger rays were found during blocking despite the use of protective hand gear. Improvement of tactical skills and blocking techniques during training and improved protective gear appear to be essential for injury prevention.

Impact of Removing the Race Coefficient in Renal Function Estimate Equations on Drug Dosage Recommendations

2021 ◽  
pp. 106002802110102
Author(s):  
Janine Miller ◽  
John P. Knorr
Keyword(s):  
Filtration Rate ◽  
Drug Dosage ◽  
Drug Dose ◽  
Epidemiology Study ◽  
Black African ◽  
Drug Dosing ◽  
Disease Epidemiology ◽  
Black Patients ◽  
The Impact ◽  
Level Of Agreement

Background The appropriateness of including the race coefficient in glomerular filtration rate (GFR) equations in Black patients is debated, and the impact on drug dosing is unknown. Objective This study explored the impact of removing the race coefficient on drug dosing in Black patients in comparison to conventional methods. Methods This was a retrospective study of hospitalized patients who self-identified as Black/African American and were prescribed an antimicrobial that includes renal dosage recommendations in the product labeling. The primary end point was the discordance between drug dosing recommendations derived by body surface area deindexed GFR estimated by the CKD-EPI equation (Chronic Kidney Disease Epidemiology study) with and without race versus recommendations derived from Cockcroft-Gault (CG). Results A total of 210 Black patients were included. There was an 18% rate of discordance when GFR was estimated with the race coefficient (GFR w/Race) versus without the race coefficient (GFR w/out Race). GFR w/out Race had a higher level of agreement with dosing by creatinine clearance (CrCl; κ = 0.779) than GFR w/Race versus CrCl (κ = 0.651). GFR w/out Race had less within-patient difference than GFR w/Race in comparison to CrCl (mean difference: −6.3 vs −18.0 mL/min). Conclusions and Relevance This represents the first report to examine the removal of the race coefficient and its implication on drug dose discordance. GFR w/out Race had a higher level of agreement and less drug dose discordance than GFR w/Race, in comparison to CrCl estimates. If GFR equations are considered comparable to CrCl for the purposes of guiding drug dosing, GFR w/out Race should be considered.

scholarly journals EPID-10. EPIDEMIOLOGY STUDY OF UNCOMMON CHILDHOOD BRAIN TUMOURS IN ASIAN CHILDREN

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii320-iii320
Author(s):  
Godfrey Chi-Fung Chan ◽  
Anthony Pak-Yin Liu ◽  
Matthew Ming-Kong Shing ◽  
Dennis Tak-Noi Ku
Keyword(s):  
Choroid Plexus ◽  
Brain Tumours ◽  
Clinical Characteristics ◽  
Interferon Beta ◽  
Choroid Plexus Papilloma ◽  
Epidemiology Study ◽  
Childhood Brain Tumours ◽  
Post Surgery ◽  
Asian Children ◽  
Multiple Recurrences

Abstract Our local registry identified 656 brain tumours from Jan 1999 to Dec 2018, (incidence: 29.8/yr/million). Other from Glioma, Medulloblastoma/PNET, Germ Cell tumours, Ependymoma, the remaining rarer tumours accounted for 18% (n=118). The 7 more common groups are: craniopharyngioma(n=28); ATRT(n=18); choroid plexus papilloma/CA(n=12); Ganglioglioma(n=11); ETMR(n=7); DNET(n=7); meningioma(n=6). Their respective incidences are 1.27; 0.81; 0.55; 0.5; 0.32; 0.32 0.27/yr/million. For craniopharyngioma, M:F=15:13 and median age was 7.4yrs (2mons-16.5yrs). 12/28 children had surgery alone and 13/28 had focal RT post-surgery with better outcome. 3 underwent intra-cystic interferon-beta also stable. For ATRT, M:F=7:8 and median age was 2.3yrs (4mos-14.2yrs). 2 had metastatic disease and 7/18 patients remained alive. For choroid plexus tumours, there were 7 papilloma, 2 atypia and 3 carcinoma. M:F=5:6 and median age was 1.5yrs (4mos-14yrs). All papilloma, 1/2 atypia and 1/3 carcinoma survived. For ganglioglioma, M:F=7:4 with median age of 5.5yrs (5mos-13.2yrs). They commonly presented with seizure and only one died (brainstem primary). The ETMR includes ependymoblastoma and medulloepithelioma, they had quite different clinical characteristics and outcome. 6/7 DNET had convulsion and M:F=6:1. Median age was 11.5yrs (2.66-14yrs). They all survived even if incompletely resected. For meningioma, 1/6 had germline mutation of NF-2 gene. M:F=3:3 and onset was &gt;8yrs except the NF-2 patient. All survived but the NF-2 had multiple recurrences. 4 patients developed secondary meningioma due to irradiation but they were &gt;18yrs so excluded. In summary, rarer forms of childhood brain tumours only accounted for &lt;20% of all brain tumours and they had diverse presenting features and outcome.

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