scholarly journals 0636 Using AI To Predict Future CPAP Adherence and the Impact of Behavioral and Technical Interventions

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A243-A243
Author(s):  
W Hevener ◽  
B Beine ◽  
J Woodruff ◽  
D Munafo ◽  
C Fernandez ◽  
...  
Keyword(s):  
Effect Size ◽  
Statistical Significance ◽  
Post Intervention ◽  
Cpap Adherence ◽  
Cohen’S D ◽  
Usage Patterns ◽  
Patient Outreach ◽  
Cohen's D ◽  
The Impact ◽  
Usage Data

Abstract Introduction Clinical management of CPAP adherence remains an ongoing challenge. Behavioral and technical interventions such as patient outreach, coaching, troubleshooting, and resupply may be deployed to positively impact adherence. Previous authors have described adherence phenotypes that retrospectively categorize patients by discrete usage patterns. We design an AI model that predictively categorizes patients into previously studied adherence phenotypes and analyzes the statistical significance and effect size of several types of interventions on subsequent CPAP adherence. Methods We collected a cross-sectional cohort of subjects (N = 13,917) with 455 days of daily CPAP usage data acquired. Patient outreach notes and resupply data were temporally synchronized with daily CPAP usage. Each 30-days of usage was categorized into one of four adherence phenotypes as defined by Aloia et al. (2008) including Good Users, Variable Users, Occasional Attempters, and Non-Users. Cross-validation was used to train and evaluate a Recurrent Neural Network model for predicting future adherence phenotypes based on the dynamics of prior usage patterns. Two-sided 95% bootstrap confidence intervals and Cohen’s d statistic were used to analyze the significance and effect size of changes in usage behavior 30-days before and after administration of several resupply interventions. Results The AI model predicted the next 30-day adherence phenotype with an average of 90% sensitivity, 96% specificity, 95% accuracy, and 0.83 Cohen’s Kappa. The AI model predicted the number of days of CPAP non-use, use under 4-hours, and use over 4-hours for the next 30-days with OLS Regression R-squared values of 0.94, 0.88, and 0.95 compared to ground truth. Ten resupply interventions were associated with statistically significant increases in adherence, and ranked by adherence effect size using Cohen’s d. The most impactful were new cushions or masks, with a mean post-intervention CPAP adherence increase of 7-14% observed in Variable User, Occasional Attempter, and Non-User groups. Conclusion The AI model applied past CPAP usage data to predict future adherence phenotypes and usage with high sensitivity and specificity. We identified resupply interventions that were associated with significant increases in adherence for struggling patients. This work demonstrates a novel application for AI to aid clinicians in maintaining CPAP adherence. Support  

Is Prolonged Operation Time a Predictor for the Occurrence of Complications in Ureteroscopy?

2015 ◽  
Vol 95 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Sophie Knipper ◽  
Christian Tiburtius ◽  
Andreas J. Gross ◽  
Christopher Netsch
Keyword(s):  
Retrospective Analysis ◽  
Effect Size ◽  
Operation Time ◽  
Interquartile Range ◽  
Complication Rates ◽  
Prolonged Operation ◽  
Cohen’S D ◽  
Level Of Significance ◽  
Cohen's D ◽  
The Impact

Objective: To determine the impact of duration of ureteroscopy for urolithiasis on complication rates (CRs) of the procedure. Methods: A retrospective analysis of 2,010 patients, treated between 2006 and 2011, was done. The operation time (OT) and the occurrence of complications were compared. Results: The overall CR was 14.3% [298 complications, minor complications (Clavien I-II) 91.7%]. The median OT was 35 min [interquartile range (IQR) 20-61]. The OT differed significantly between those without complications [34 min (IQR 20-60)] and those with complications [45 min (IQR 25-76)] (p < 0.0001). The correlation between the OT and the occurrence of complications (r = -0.009648, p < 0.0001) was very weak and passed the level of significance (r = 0.2). The effect size was of minor relevance (Cohen's d = 0.27972). Conclusions: Longer OT correlates significantly with a higher CR. The effect is however shown to be minor and the overall rate of complications, especially severe ones, is low.

Improving Self-Reported Empathy and Communication Skills Through Harm in Healthcare Response Training

2021 ◽  
pp. 251604352110476
Author(s):  
Aimee Samuels ◽  
Marion E. Broome ◽  
Timothy B. McDonald ◽  
Chii-Hui Peterson ◽  
Julie A. Thompson
Keyword(s):  
Communication Skills ◽  
Effect Size ◽  
Cognitive Complexity ◽  
Statistical Significance ◽  
Healthcare Organizations ◽  
Response Training ◽  
Cohen’S D ◽  
Moderate Effect Size ◽  
Moderate Effect ◽  
Cohen's D

Objective Communication and Resolution Programs (CRP) were developed to equip healthcare organizations with tools to respond when physical and psychological harm occurs. Our objective was to assess development of empathic behaviors and communication skills through CRP training based upon the Agency for Healthcare Research and Quality (AHRQ) CANDOR toolkit to assess the ability to develop and improve empathic behaviors and communication skills. Methods The Jefferson Scale of Empathy, the CANDOR Communication Assessment Questionnaire and a self-assessment were used pre- and post-intervention to analyze development of empathy, growth of communication, and improvement in confidence and knowledge through 6 h of virtual education over a six-week course. Results Self-reported communication, confidence and knowledge improved with statistical significance and small to moderate effect size in both men and women. A statistically significant improvement of self-reported empathy scores t (22)  =  2.23, p  =  .037; (95% CI  =  0.41 to 11.5) for women only represented a small to moderate effect size (Cohen’s d  =  0.46). While there was no improvement in Cognitive Complexity, (Cohen’s d  =  0.065) mean pre-post .42 (SD  =  6.52); Message Design Logic improved with statistical significance in paired pre-and post-assessment (Z  =  -3.28, p  =  .001). Notably, previous attendance at CANDOR classes demonstrated no impact on improvement of scores. Conclusions Our findings demonstrate improvement in self-reported empathy and communication skills through harm in healthcare response training. Healthcare organizations should carefully consider investing in CANDOR training for the benefit of patients, their families, and healthcare workforce members.

Development of a multimedia intervention to improve pneumoconiosis prevention in construction workers using RE-AIM framework

2021 ◽  
Author(s):  
Jieling Chen ◽  
Cho Lee Wong ◽  
Bernard Man Hin Law ◽  
Winnie Kwok Wei So ◽  
Doris Yin Ping Leung ◽  
...  
Keyword(s):  
South Asian ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Intervention Mapping ◽  
Intervention Development ◽  
Educational Interventions ◽  
Construction Workers ◽  
Post Intervention ◽  
Cohen’S D ◽  
Cohen's D

Summary Pneumoconiosis is a common occupational lung disease among construction workers. Educational interventions targeting specific ethnic groups of construction workers are of benefit for pneumoconiosis prevention. The aim of this study was to develop a multimedia educational intervention for pneumoconiosis prevention for South Asian construction workers, and to evaluate its feasibility, acceptability and effectiveness in increasing knowledge of pneumoconiosis, modifying beliefs about pneumoconiosis, and enhancing intention to implement measures for its prevention among the workers. This evaluation was performed using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. A one-group design was adopted and intervention mapping was used to guide the process of intervention development, while the Health Belief Model guided the development of intervention content. The intervention was delivered at construction sites, ethnic minority associations and South Asian community centres. Data were collected via surveys completed at pre-intervention, post-intervention and 3 months after the intervention. A total of 1002 South Asian construction workers participated in the intervention. The participants reported a moderate-to-large increase in knowledge, perceived susceptibility, perceived severity, perceived benefits, cues to action and self-efficacy (Cohen’s d: 0.37–0.89), a small reduction in perceived barriers (Cohen’s d = 0.12) and a moderate improvement in attitudes and intention to practice (Cohen’s d: 0.45, 0.51) at post-intervention. A follow-up survey of 121 participants found that the implementation of preventive measures appeared to increase. Overall, the findings demonstrate that the implementation of a culturally adapted multimedia educational intervention could be an effective approach to improving knowledge, self-efficacy and intention regarding pneumoconiosis prevention among South Asian construction workers.

scholarly journals Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Leonice Fumiko Sato Kurebayashi ◽  
Ruth Natalia Teresa Turrini ◽  
Talita Pavarini Borges de Souza ◽  
Carolina Felicio Marques ◽  
Renata Tavares Franco Rodrigues ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Nursing Staff ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Cohen’S D ◽  
Pain Visual Analog Scale ◽  
Cohen's D

RESUMEN Objectives: to evaluate the effectiveness of the auricular protocol (APPA) in reducing pain and anxiety and improving the quality of life of the nursing staff of a hospital. Method: randomized clinical trial with an initial sample of 180 professionals divided into 4 groups Control (G1), Seed (G2), Needle (G3) and Tape (G4). The evaluation instruments were the State-Trait Anxiety Inventory, Pain Visual Analog Scale and Quality of Life instrument, applied at the start and after five and 10 sessions (five weeks). Descriptive statistics, analysis of variance (ANOVA) and Cohen's d Index were used in the analysis. Results: there was a statistical difference (p < 0.05) for anxiety according to the repeated measures ANOVA, with better results for the G3 in the final assessment (Cohen's d index 1.08/17% reduction). There was a reduction of pain of 36% in G3 and 24% in G2 and a 13% increase in the mental aspect of quality of life for the G3, although without statistical significance. Conclusion: the APPA protocol reduced the anxiety levels of nursing staff after 10 sessions. Further studies are, however, suggested with new populations and in different contexts so that the results can be confirmed. RBR-5pc43m.

scholarly journals The Impact of Replacement Conventional Dentures on Eating Experience

2018 ◽  
Vol 4 (1) ◽  
pp. 29-40 ◽  
Author(s):  
H.F. Al-Sultani ◽  
J.C. Field ◽  
J.M. Thomason ◽  
P.J. Moynihan
Keyword(s):  
Quality Of Life ◽  
Social Issues ◽  
Complete Dentures ◽  
Social And Emotional ◽  
Cohen’S D ◽  
Related Quality ◽  
Emotional Issues ◽  
Cohen's D ◽  
The Impact

Introduction: Despite much research on the impact of edentulism and prosthetic rehabilitation on food and nutrient intake, there is little information on how replacing complete dentures affects social and emotional issues around eating. Objectives: To investigate, in a cohort study, how replacing conventional complete dentures affects eating-related quality of life (ERQoL). A secondary aim was to test the responsiveness of an Emotional and Social Issues Related to Eating (ESIRE) questionnaire to change in ERQoL. Methods: Participants, recruited from the Dental Hospital, Newcastle-upon-Tyne, UK, completed the self-administrated ESIRE questionnaire before and after provision of new conventional complete dentures. Paired t test was used to determine any change between pre- and posttreatment ESIRE scores, which can range from 0 (poor) to 100 (excellent). Cohen’s d effect size was used to measure the magnitude of change in ERQoL. Standardized response mean (SRM) was used to measure the responsiveness of the ESIRE questionnaire to changes in ERQoL. Results: Fifty-five participants aged 52 to 85 y (mean, 72 y), including 21 males (42%) and 29 females (58%), completed the study. A statistically significant improvement in the total ESIRE scores was found, mean (SE) +20.3 (3.30), P < 0.001. Equally, all domains of the ESIRE questionnaire showed significant improvements: enjoyment of food/eating, +27.3 (3.63), P < 0.001; self-consciousness/embarrassment, +18.1 (3.88), P < 0.001; interruption to meals, +13.3 (5.27), P < 0.05; confidence when eating, +18.7 (4.84), P < 0.001; time for eating/preparation of meals, +18.5 (4.85), P < 0.001); and functional ability to eat, +18.2 (3.67), P < 0.001). Cohen’s d was large (0.95) for the total score and ranged from medium (0.37) to large (1.30) for all domains. Value of SRM was large (0.87) for the total score and ranged from medium (0.36) to large (1.1) for all domains. Conclusion: Denture replacement can directly improve ERQoL. The ESIRE questionnaire was responsive to clinically important changes in ERQoL. Knowledge Transfer Statement: The results of this study improve the understanding of the impact of denture replacement on eating-related quality of life (ERQoL). Clinicians are encouraged to pay more attention to the impact of wearing conventional complete dentures on social and emotional issues around eating. The findings should motivate clinicians and inspire specialists in prosthodontics and oral rehabilitation to continue providing conventional complete dentures as a suitable treatment option for edentulous patients.

scholarly journals Preliminary Evaluation of the Engagement and Effectiveness of a Mental Health Chatbot

2020 ◽  
Author(s):  
Kate Daley
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Preliminary Evaluation ◽  
Real World Data ◽  
Post Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cohen’S D ◽  
Cohen's D ◽  
Human Support

Background: Mental health difficulties are highly prevalent yet access to support is impeded by barriers of stigma, cost and availability. These issues are even more prevalent in low- and middle-income countries, and use of digital technology is one way to overcome these barriers. Digital health interventions have been shown to be effective but often struggle with low engagement rates, particularly in the absence of any human support. Chatbots could offer a scalable solution, simulating human support at a lower cost. Objective: To complete a preliminary evaluation of engagement and effectiveness of Vitalk, a mental health chatbot, at reducing anxiety, depression and stress. Methods: Real world data was analysed from 3629 Vitalk users who had completed the first phase of a Vitalk program (‘less anxiety’, ‘less stress’ or ‘better mood’). Programs were delivered through written conversation with the chatbot. Engagement was calculated from the number of responses sent to the chatbot divided by days in the program. Results: Users sent an average of 8.17 responses / day. For all three programs, target outcome scores reduced between baseline and follow up with large effect sizes for anxiety (Cohen's d = -0.85), depression (Cohen's d = -0.91) and stress (Cohen's d =-0.81). Increased engagement resulted in improved post-intervention values for anxiety and depression. Conclusion: This study highlights the potential of a chatbot to reduce mental health symptoms in the general population within Brazil. Whilst findings show promise, further research is required.

A non-parametric effect size measure capturing changes in central tendency and shape of data distributions more flexibly than Cohen’s d

2020 ◽  
Author(s):  
Jörn Lötsch ◽  
Alfred Ultsch
Keyword(s):  
Effect Size ◽  
Data Science ◽  
Heterogeneous Data ◽  
Machine Learning Algorithms ◽  
Central Tendency ◽  
Effect Size Measure ◽  
Specific Data ◽  
Cohen’S D ◽  
Size Measure ◽  
Cohen's D

Abstract Calculating the magnitude of treatment effects or of differences between two groups is a common task in quantitative science. Standard effect size measures based on differences, such as the commonly used Cohen's, fail to capture the treatment-related effects on the data if the effects were not reflected by the central tendency. "Impact” is a novel nonparametric measure of effect size obtained as the sum of two separate components and includes (i) the change in the central tendency of the group-specific data, normalized to the overall variability, and (ii) the difference in the probability density of the group-specific data. Results obtained on artificial data and empirical biomedical data showed that impact outperforms Cohen's d by this additional component. It is shown that in a multivariate setting, while standard statistical analyses and Cohen’s d are not able to identify effects that lead to changes in the form of data distribution, “Impact” correctly captures them. The proposed effect size measure shares the ability to observe such an effect with machine learning algorithms. It is numerically stable even for degenerate distributions consisting of singular values. Therefore, the proposed effect size measure is particularly well suited for data science and artificial intelligence-based knowledge discovery from (big) and heterogeneous data.

scholarly journals Can a virtual microbiology simulation be as effective as the traditional Wetlab for pharmacy student education?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
L. Baumann-Birkbeck ◽  
S. Anoopkumar-Dukie ◽  
S. A. Khan ◽  
M. J. Cheesman ◽  
M. O’Donoghue ◽  
...  
Keyword(s):  
Learning Outcomes ◽  
Professional Education ◽  
Statistical Significance ◽  
Pharmacy Practice ◽  
Pharmacy Students ◽  
Technology Enhanced Learning ◽  
Multiple Choice Questions ◽  
Post Intervention ◽  
The Impact ◽  
Enhanced Learning

Abstract Background Pharmacy practice education requires the development of proficiencies and an understanding of clinical microbiology. Learning in this area could be delivered using practical laboratory exercises, or potentially, simulation-based education. Simulation has previously successfully enhanced learning in health professional education. The current global climate due to COVID-19 has further highlighted the important role of technology-enhanced learning in delivering outcomes that meet the requisite learning objectives of a course. The aim of the present study was to compare the impact of a commercially available virtual microbiology simulation (VUMIE™) with a traditional wet laboratory (wetlab) on learner knowledge, skills and confidence in a second-year integrated pharmacotherapeutics course for Bachelor of Pharmacy students. Methods A randomised, crossover study was employed to determine whether the simulation intervention (VUMIE™) improves learning outcomes (knowledge, skills and confidence) of pharmacy students, when compared to a traditional wetlab intervention. Each student completed three 1–2 h length sessions, for both the wetlab and VUMIE™ interventions (6 sessions total). Data was collected using surveys deployed at baseline (pre-interventions), post-intervention 1 or 2 (VUMIE™ or wetlab) and endpoint (post-interventions 1 and 2). Statistical analysis was conducted using SPSS Statistics 25 and Instat™ software. Results Response rates were approximately 50% at initial survey and approximately 25% at endpoint survey. VUMIE™ produced higher post-intervention knowledge scores for the multiple-choice questions compared to the wetlab, however, the highest score was achieved at endpoint. Both interventions produced statistically significant differences for mean scores compared to baseline (pre-VUMIE™ and wetlab) across the domains of knowledge, skills and confidence. VUMIE™ produced higher post-intervention mean scores for knowledge, skills and confidence compared to post-intervention mean scores for the wetlab, however there was no statistical significance between the mean score for the two interventions, thus the VUMIE™ activity produced learning outcomes comparable to the wetlab activity. Conclusion These findings suggest VUMIE™ provides similar effects on students’ knowledge, skills, and confidence as a wetlab. The simulation’s implementation was not cost-prohibitive, provided students with a physically and psychologically safe learning environment, and the benefit of being able to repeat activities, supporting deliberate practice.

scholarly journals The impact of a community based rehabilitation program in Afghanistan: a longitudinal analysis using propensity score matching and difference in difference analysis

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jean-Francois Trani ◽  
Juanita Vasquez-Escallon ◽  
Parul Bakhshi
Keyword(s):  
Daily Living ◽  
Well Being ◽  
Medium Effect ◽  
Community Based ◽  
Persons With Disabilities ◽  
Cohen’S D ◽  
Community Based Rehabilitation ◽  
Medium Effect Size ◽  
Cohen's D ◽  
The Impact

Abstract Background The 2006 United Nations Convention on the Rights of Persons with Disabilities states that the achievement of equal rights, empowerment and social inclusion of people with disabilities requires comprehensive rehabilitation services encompassing all components of the World Health Organization Community based rehabilitation (CBR) matrix: health, education, livelihood, social and empowerment. CBR programs specifically aim to deliver such comprehensive interventions. In the present study, we investigate the impact of a CBR program in Afghanistan on all these components. Methods We enrolled 1861 newly recruited CBR participants with disabilities in the study, from 169 villages between July 2012 and December 2013 as well as 1132 controls with disabilities randomly selected through a two-stage process within 6000 households from 100 villages in the same provinces but outside the catchment area of the CBR program. We interviewed them again after one (midline) and two (end-line) years in the study. Using propensity score matching and difference in difference analysis, we estimated the impact of the CBR on outcomes of interest, namely mobility, activities of daily living, communication, participation in social and community life, emotional well-being and employment. Results Three years on average into the CBR program, participants showed a significant and close to medium effect size reduction in emotional (Cohen’s d = − 0.48, 95%CI[− 0.58--0.38]), and social participation challenges (Cohen’s d = − 0.45, 95%CI[− 0.53−− 0.36]); small to medium effect size reduction in unemployment (Cohen’s d = − 0.21, 95%CI[− 0.33--0.10]), activities of daily living (Cohen’s d = − 0.26, 95%CI[− 0.35--0.18]), mobility (Cohen’s d = − 0.36, 95%CI[− 0.44--.29]) and communication challenges (Cohen’s d = − 0.38, 95%CI[− 0.46--0.3]). Conclusions Our study indicates that a CBR program may provide positive rehabilitation outcomes for persons with disabilities even in a conflict context, and improve overall well-being of all participants with disabilities, whatever their impairment, individual characteristics and the CBR matrix components considered. Trial registration ISRCTN, ISRCTN50214054. Registered August 5th 2020 - retrospectively registered

scholarly journals The Unforgettables: a chorus for people with dementia with their family members and friends

2018 ◽  
Vol 30 (6) ◽  
pp. 779-789 ◽  
Author(s):  
Mary Sherman Mittelman ◽  
Panayiota Maria Papayannopoulou
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Pilot Study ◽  
Effect Size ◽  
Family Members ◽  
Positive Effects ◽  
Cohen’S D ◽  
People With Dementia ◽  
Cohen's D

Summary/AbstractOur experience evaluating a museum program for people with dementia together with their family members demonstrated benefits for all participants. We hypothesized that participation in a chorus would also have positive effects, giving them an opportunity to share a stimulating and social activity that could improve their quality of life. We inaugurated a chorus for people with dementia and their family caregivers in 2011, which rehearses and performs regularly. Each person with dementia must be accompanied by a friend or family member and must commit to attending all rehearsals and the concert that ensues. A pilot study included a structured assessment, take home questionnaires and focus groups. Analyses of pre-post scores were conducted; effect size was quantified using Cohen's d. Results showed that quality of life and communication with the other member of the dyad improved (Effect size: Cohen's d between 0.32 and 0.72) for people with dementia; quality of life, social support, communication and self-esteem improved (d between 0.29 and 0.68) for caregivers. Most participants stated that benefits included belonging to a group, having a normal activity together and learning new skills. Participants attended rehearsals in spite of harsh weather conditions. The chorus has been rehearsing and performing together for more than 6 years and contributing to its costs. Results of this pilot study suggest that people in the early to middle stage of dementia and their family members and friends can enjoy and learn from rehearsing and performing in concerts that also engage the wider community. It is essential to conduct additional larger studies of the benefits of participating in a chorus, which may include improved quality of life and social support for all, and reduced cognitive decline among people with dementia.

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