scholarly journals Reference values for intake of 6 types of soluble and insoluble fibre in healthy UK inhabitants based on the UK Biobank data

2021 ◽  
pp. 1-41
Author(s):  
Artem Shevlyakov ◽  
Dimitri Nikogosov ◽  
Leigh-Ann Stewart ◽  
Miguel Toribio-Mateas
Keyword(s):  
Reference Values ◽  
Real World ◽  
Dietary Fibre ◽  
Specific Reference ◽  
Uk Biobank ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Different Types ◽  
The Uk

Abstract Objective: To obtain a set of reference values for the intake of different types of dietary fibre in a healthy UK population. Design: This descriptive cross-sectional study used the UK Biobank data to estimate the dietary patterns of healthy individuals. Data on fibre content in different foods were used to calculate the reference values which were then calibrated using real-world data on total fibre intake. Setting: UK Biobank is a prospective cohort study of over 500,000 individuals from across the United Kingdom with the participants aged between 40 and 69 years. Participants: UK Biobank contains information on over 500,000 participants. This study was performed using the data on 19990 individuals (6941 men, 13049 women) who passed stringent quality control and filtering procedures and had reported above-zero intake of the analysed foods. Results: A set of reference values for the intake of 6 different types of soluble and insoluble fibres (cellulose, hemicelluloses, pectin and lignin), including the corresponding totals, was developed and calibrated using real-world data. Conclusions: To our knowledge, this is the first study to establish specific reference values for the intake of different types of dietary fibre. It is well-known that effects exerted by different types of fibre both directly and through modulation of microbiota are numerous. Conceivably, a deficit or excess intake of specific types of dietary fibre may detrimentally affect human health. Filling this knowledge gap opens new avenues for research in discussion in studies of nutrition and microbiota, and offers valuable tools for practitioners worldwide.

scholarly journals Comparative analysis of methods for identifying multimorbidity patterns: a study of ‘real-world’ data

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018986 ◽  
Author(s):  
Albert Roso-Llorach ◽  
Concepción Violán ◽  
Quintí Foguet-Boreu ◽  
Teresa Rodriguez-Blanco ◽  
Mariona Pons-Vigués ◽  
...  
Keyword(s):  
Real World ◽  
Hierarchical Cluster ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Data Usage ◽  
Classification Of Diseases ◽  
Depth Study

ObjectiveThe aim was to compare multimorbidity patterns identified with the two most commonly used methods: hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) in a large primary care database. Specific objectives were: (1) to determine whether choice of method affects the composition of these patterns and (2) to consider the potential application of each method in the clinical setting.DesignCross-sectional study. Diagnoses were based on the 263 corresponding blocks of the International Classification of Diseases version 10. Multimorbidity patterns were identified using HCA and EFA. Analysis was stratified by sex, and results compared for each method.Setting and participantsElectronic health records for 408 994 patients with multimorbidity aged 45–64 years in 274 primary health care teams from 2010 in Catalonia, Spain.ResultsHCA identified 53 clusters for women, with just 12 clusters including at least 2 diagnoses, and 15 clusters for men, all of them including at least two diagnoses. EFA showed 9 factors for women and 10 factors for men. We observed differences by sex and method of analysis, although some patterns were consistent. Three combinations of diseases were observed consistently across sex groups and across both methods: hypertension and obesity, spondylopathies and deforming dorsopathies, and dermatitis eczema and mycosis.ConclusionsThis study showed that multimorbidity patterns vary depending on the method of analysis used (HCA vs EFA) and provided new evidence about the known limitations of attempts to compare multimorbidity patterns in real-world data studies. We found that EFA was useful in describing comorbidity relationships and HCA could be useful for in-depth study of multimorbidity. Our results suggest possible applications for each of these methods in clinical and research settings, and add information about some aspects that must be considered in standardisation of future studies: spectrum of diseases, data usage and methods of analysis.

Quantifying the diagnostic pathway for patients with cognitive impairment: real-world data from Australia

2019 ◽  
Vol 32 (5) ◽  
pp. 601-610
Author(s):  
Christopher M. Black ◽  
Michael Woodward ◽  
Baishali M. Ambegaonkar ◽  
Alana Philips ◽  
James Pike ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Real World ◽  
Public Awareness ◽  
Cross Sectional Survey ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Diagnostic Pathway ◽  
Initial Symptoms ◽  
Mean Time

ABSTRACTObjectives:Rapid diagnosis of dementia is essential to ensure optimum patient care. This study used real-world data to quantify the dementia diagnostic pathway in Australia.Design:A real-world, cross-sectional survey of physicians and patients.Setting:Clinical practice.Participants:Primary care or specialist physicians managing patients with cognitive impairment (CI).Measurements:Descriptive analyses focused on key events in the diagnostic pathway. Regression modeling compared the duration between first consultation and formal diagnosis with various factors.Results:Data for 600 patients were provided by 60 physicians. Mean time from initial symptoms to first consultation was 6.1 ± 4.4 months; 20% of patients had moderate or severe CI at first consultation. Mean time from first consultation to formal diagnosis was 4.0 ± 7.4 months (1.2 ± 3.6 months if not referred to a secondary physician, and 5.3 ± 8.3 months if referred). Time from first consultation to diagnosis was significantly associated with CI severity at first consultation; time was shorter with more severe CI. There was no association of disease severity and referral to a secondary physician; 69.5% of patients were referred, the majority (57.1%) to a geriatrician. The highest proportion of patients were diagnosed by geriatricians (47.4%). Some form of test or scale was used to aid diagnosis in 98.8% of patients.Conclusions:A substantial number of Australians experience cognitive decline and behavioral changes some time before consulting a physician or being diagnosed with dementia. Increasing public awareness of the importance of early diagnosis is essential to improve the proportion of patients receiving comprehensive support prior to disease progression.

scholarly journals Real-world data from expanded access programmes in health technology assessments: a review of NICE technology appraisals

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052186
Author(s):  
Tobias B Polak ◽  
David GJ Cucchi ◽  
Joost van Rosmalen ◽  
Carin A Uyl-de Groot
Keyword(s):  
Resource Use ◽  
Real World ◽  
Treatment Options ◽  
Health Technology ◽  
Primary Outcome Measure ◽  
Disease Area ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Expanded Access

ObjectivesTo quantify and characterise the usage of expanded access (EA) data in National Institute for Health and Care Excellence (NICE) technology appraisals (TAs). EA offers patients who are ineligible for clinical trials or registered treatment options, access to investigational therapies. Although EA programmes are increasingly used to collect real-world data, it is unknown if and how these date are used in NICE health technology assessments.DesignCross-sectional study of NICE appraisals (2010–2020). We automatically downloaded and screened all available appraisal documentation on NICE website (over 8500 documents), searching for EA-related terms. Two reviewers independently labelled the EA usage by disease area, and whether it was used to inform safety, efficacy and/or resource use. We qualitatively describe the five appraisals with the most occurrences of EA-related terms.Primary outcome measureNumber of TAs that used EA data to inform safety, efficacy and/or resource use analyses.ResultsIn 54.2% (206/380 appraisals), at least one reference to EA was made. 21.1% (80/380) of the TAs used EA data to inform safety (n=43), efficacy (n=47) and/or resource use (n=52). The number of TAs that use EA data remained stable over time, and the extent of EA data utilisation varied by disease area (p=0.001).ConclusionNICE uses EA data in over one in five appraisals. In synthesis with evidence from well-controlled trials, data collected from EA programmes may meaningfully inform cost-effectiveness modelling.

scholarly journals Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study)

2021 ◽  
Vol 18 (5) ◽  
pp. 2244
Author(s):  
M. Rosa Dalmau Llorca ◽  
Carina Aguilar Martín ◽  
Noèlia Carrasco-Querol ◽  
Zojaina Hernández Rojas ◽  
Emma Forcadell Drago ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Real World ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data

Background: Oral anticoagulants (OAs) are the treatment to prevent stroke in atrial fibrillation (AF). Anticoagulant treatment choice in non-valvular atrial fibrillation (NVAF) must be individualized, taking current guidelines into account. Adequacy of anticoagulant therapy under the current criteria for NVAF in real-world primary care is presented. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in Primary Care (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centers in 2018. Results: In total, 41,430 (68%) were treated with vitamin K antagonists (VKAs) and 19,548 (32%) NVAF with direct-acting oral anticoagulants (DOACs). Inadequate prescription was estimated to be 36.0% and 67.6%, respectively. Most DOAC inadequacy (77.3%) was due to it being prescribed as a first-line anticoagulant when there was no history of thromboembolic events or intracranial hemorrhage (ICH). A total of 22.1% had missing estimated glomerular filtration rate (eGFR) values. Common causes of inadequate VKA prescription were poor control of time in therapeutic range (TTR) (98.8%) and ICH (2.2%). Conclusions: Poor adequacy to current criteria was observed, being inadequacy higher in DOACs than in VKAs. TTR and GFR should be routinely calculated in electronic health records (EHR) to facilitate decision-making and patient safety.

scholarly journals Cardiovascular magnetic resonance reference values of mitral and tricuspid annular dimensions: the UK Biobank cohort

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Fabrizio Ricci ◽  
Nay Aung ◽  
Sabina Gallina ◽  
Filip Zemrak ◽  
Kenneth Fung ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Reference Values ◽  
Intraclass Correlation ◽  
Specific Reference ◽  
Reference Ranges ◽  
Uk Biobank ◽  
Chamber View ◽  
The Uk ◽  
Age And Sex

Abstract Background Mitral valve (MV) and tricuspid valve (TV) apparatus geometry are essential to define mechanisms and etiologies of regurgitation and to inform surgical or transcatheter interventions. Given the increasing use of cardiovascular magnetic resonance (CMR) for the evaluation of valvular heart disease, we aimed to establish CMR-derived age- and sex-specific reference values for mitral annular (MA) and tricuspid annular (TA) dimensions and tethering indices derived from truly healthy Caucasian adults. Methods 5065 consecutive UK Biobank participants underwent CMR using cine balanced steady-state free precession imaging at 1.5 T. Participants with non-Caucasian ethnicity, prevalent cardiovascular disease and other conditions known to affect cardiac chamber size and function were excluded. Absolute and indexed reference ranges for MA and TA diameters and tethering indices were stratified by gender and age (45–54, 55–64, 65–74 years). Results Overall, 721 (14.2%) truly healthy participants aged 45–74 years (54% women) formed the reference cohort. Absolute MA and TA diameters, MV tenting length and MV tenting area, were significantly larger in men. Mean ± standard deviation (SD) end-diastolic and end-systolic MA diameters in the 3-chamber view (anteroposterior diameter) were 2.9 ± 0.4 cm (1.5 ± 0.2 cm/m2) and 3.3 ± 0.4 cm (1.7 ± 0.2 cm/m2) in men, and 2.6 ± 0.4 cm (1.6 ± 0.2 cm/m2) and 3.0 ± 0.4 cm (1.8 ± 0.2 cm/m2) in women, respectively. Mean ± SD end-diastolic and end-systolic TA diameters in the 4-chamber view were 3.2 ± 0.5 cm (1.6 ± 0.3 cm/m2) and 3.2 ± 0.5 cm (1.7 ± 0.3 cm/m2) in men, and 2.9 ± 0.4 cm (1.7 ± 0.2 cm/m2) and 2.8 ± 0.4 cm (1.7 ± 0.3 cm/m2) in women, respectively. With advancing age, end-diastolic TA diameter became larger and posterior MV leaflet angle smaller in both sexes. Reproducibility of measurements was good to excellent with an inter-rater intraclass correlation coefficient (ICC) between 0.92 and 0.98 and an intra-rater ICC between 0.90 and 0.97. Conclusions We described age- and sex-specific reference ranges of MA and TA dimensions and tethering indices in the largest validated healthy Caucasian population. Reference ranges presented in this study may help to improve the distinction between normal and pathological states, prompting the identification of subjects that may benefit from advanced cardiac imaging for annular sizing and planning of valvular interventions.

scholarly journals ADES: A New Ensemble Diversity-Based Approach for Handling Concept Drift

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Tinofirei Museba ◽  
Fulufhelo Nelwamondo ◽  
Khmaies Ouahada
Keyword(s):  
Machine Learning ◽  
Real World ◽  
Data Streams ◽  
Predictive Models ◽  
Concept Drift ◽  
Dynamic Environments ◽  
Real World Data ◽  
World Data ◽  
Different Types ◽  
Concept Drifts

Beyond applying machine learning predictive models to static tasks, a significant corpus of research exists that applies machine learning predictive models to streaming environments that incur concept drift. With the prevalence of streaming real-world applications that are associated with changes in the underlying data distribution, the need for applications that are capable of adapting to evolving and time-varying dynamic environments can be hardly overstated. Dynamic environments are nonstationary and change with time and the target variables to be predicted by the learning algorithm and often evolve with time, a phenomenon known as concept drift. Most work in handling concept drift focuses on updating the prediction model so that it can recover from concept drift while little effort has been dedicated to the formulation of a learning system that is capable of learning different types of drifting concepts at any time with minimum overheads. This work proposes a novel and evolving data stream classifier called Adaptive Diversified Ensemble Selection Classifier (ADES) that significantly optimizes adaptation to different types of concept drifts at any time and improves convergence to new concepts by exploiting different amounts of ensemble diversity. The ADES algorithm generates diverse base classifiers, thereby optimizing the margin distribution to exploit ensemble diversity to formulate an ensemble classifier that generalizes well to unseen instances and provides fast recovery from different types of concept drift. Empirical experiments conducted on both artificial and real-world data streams demonstrate that ADES can adapt to different types of drifts at any given time. The prediction performance of ADES is compared to three other ensemble classifiers designed to handle concept drift using both artificial and real-world data streams. The comparative evaluation performed demonstrated the ability of ADES to handle different types of concept drifts. The experimental results, including statistical test results, indicate comparable performances with other algorithms designed to handle concept drift and prove their significance and effectiveness.

Sign in / Sign up

Export Citation Format

Share Document