Prescribing patterns for medical treatment of suspected prostatic obstruction: a longitudinal register-based study of the Scottish Health and Social Care Open Data

BackgroundThe diagnosis of lower urinary tract symptoms related to suspected bladder outflow obstruction from benign prostate hyperplasia/enlargement in men is increasing. This is leading to high demand on healthcare services; however, there is limited knowledge of differences in pharmacotherapy prescribing for this condition based on geography.ObjectiveTo investigate potential variation in drug prescribing for suspected bladder outflow obstruction in Scotland, based on analysis of publicly available data, to identify trends and inform future prescribing.Study designA longitudinal register-based data study of prescribing and patient data publicly available from Scottish registries. All information is available as monthly aggregates at the level of single general practices.Setting and participants903 (97%) general practices in Scotland, over a 50-month period (October 2015 to November 2019).Outcome measurements and statistical analysisWe analysed numbers of daily doses of drugs for suspected bladder outflow obstruction prescribed per month using a Bayesian Poisson regression analysis, incorporating random effects to account for spatial and temporal elements.ResultsPrescriptions for suspected bladder outflow obstruction medications increased during the observation period (overall average rate of change 1.24±0.28, ranging from 0.893 in Orkney to 1.95 in Lanarkshire). While some determinants of health inequality regarding prescribing practices across health boards are consistent with those known from the literature, other inequalities remain unexplained after accounting for practice-specific and patient-specific characteristics such as deprivation and rurality.ConclusionsInequalities in prescribing for suspected bladder outflow obstruction medications exist in Scotland, partially ascribable to accepted sociodemographic and geographic factors.

Download Full-text

Prescribing patterns for medical treatment of suspected prostatic obstruction: A spatiotemporal statistical analysis of Scottish open access data

10.1101/2020.06.19.20135459 ◽

2020 ◽

Author(s):

Federico Andreis ◽

Richard Bryant ◽

Emanuele Giorgi ◽

Andrea Williamson ◽

Ashleigh Ward

Keyword(s):

Statistical Analysis ◽

Healthcare Services ◽

Prescribing Patterns ◽

Patient Specific ◽

Ageing Population ◽

Prescribing Practices ◽

Outflow Obstruction ◽

Prostate Hyperplasia ◽

Bladder Outflow Obstruction ◽

The Impact

AbstractBackgroundHealthcare services treating men with prostate conditions are increasingly burdened worldwide. One of the competing factors in this demand is increasing diagnosis and treatment of lower urinary tract symptoms in men, much of which is suspected bladder outflow obstruction secondary to benign prostate hyperplasia/enlargement. However, the impact of increases on services is largely hidden, and there is limited knowledge of potential differences in management based on geography.ObjectiveTo investigate potential variation in the prescribing of drugs for suspected bladder outflow obstruction in Scotland based on analysis of publicly available data, and identify trends that may help to inform future prescribing behaviour.Design, setting, and participantsWe linked the relevant publicly available prescribing and patient data to all general practices in Scotland between October 2015 and November 2019.Outcome measurements and statistical analysisWe analysed the numbers of daily doses of drugs prescribed for suspected bladder outflow obstruction per month using a Bayesian Poisson regression analysis, incorporating random effects to account for spatial and temporal elements in prescribing.ResultsPrescriptions of drugs to treat suspected bladder outflow obstruction increased during the observation period in Scotland, consistent with an ageing population and increased diagnosis. Whilst some determinants of health inequality regarding prescribing practices across health boards are consistent with those known from the literature, other inequalities remain unexplained after accounting for practice- and patient-specific characteristics such as socio-economic deprivation and rurality.ConclusionsVariations in spatiotemporal prescribing for suspected bladder outflow obstruction exist in Scotland, some of which are unexplained and require further investigation.

Download Full-text

Weight Feedback-Based Harmonic MDG-Ensemble Model for Prediction of Traffic Accident Severity

Applied Sciences ◽

10.3390/app11115072 ◽

2021 ◽

Vol 11 (11) ◽

pp. 5072

Author(s):

Byung-Kook Koo ◽

Ji-Won Baek ◽

Kyung-Yong Chung

Keyword(s):

Traffic Accidents ◽

Average Rate ◽

Modern Society ◽

Rate Of Change ◽

Weighted Voting ◽

Independent Variables ◽

Dependent Variables ◽

Accident Severity ◽

Harmonic Average ◽

Bagging Method

Traffic accidents are emerging as a serious social problem in modern society but if the severity of an accident is quickly grasped, countermeasures can be organized efficiently. To solve this problem, the method proposed in this paper derives the MDG (Mean Decrease Gini) coefficient between variables to assess the severity of traffic accidents. Single models are designed to use coefficient, independent variables to determine and predict accident severity. The generated single models are fused using a weighted-voting-based bagging method ensemble to consider various characteristics and avoid overfitting. The variables used for predicting accidents are classified as dependent or independent and the variables that affect the severity of traffic accidents are predicted using the characteristics of causal relationships. Independent variables are classified as categorical and numerical variables. For this reason, a problem arises when the variation among dependent variables is imbalanced. Therefore, a harmonic average is applied to the weights to maintain the variables’ balance and determine the average rate of change. Through this, it is possible to establish objective criteria for determining the severity of traffic accidents, thereby improving reliability.

Download Full-text

Treating bladder-outflow obstruction with thermo-expandable prostate metal stents

Expert Review of Medical Devices ◽

10.1586/erd.09.13 ◽

2009 ◽

Vol 6 (4) ◽

pp. 357-363 ◽

Cited By ~ 3

Author(s):

AG Papatsoris ◽

T El-Husseiny ◽

Y Sawada ◽

T Takahashi ◽

A Nagaoka ◽

...

Keyword(s):

Metal Stents ◽

Outflow Obstruction ◽

Bladder Outflow Obstruction

Download Full-text

Acetyl L-Carnitine Slows Decline in Younger Patients With Alzheimer's Disease: A Reanalysis of a Double-Blind, Placebo-Controlled Study Using the Trilinear Approach

International Psychogeriatrics ◽

10.1017/s1041610298005304 ◽

1998 ◽

Vol 10 (2) ◽

pp. 193-203 ◽

Cited By ~ 33

Author(s):

John O. Brooks ◽

Jerome A. Yesavage ◽

Angelico Carta ◽

Daniele Bravi

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Average Rate ◽

The United States ◽

Rate Of Change ◽

Disease Assessment ◽

Controlled Study ◽

Double Blind ◽

Parallel Group ◽

Longitudinal Effects

Objectives: To assess the longitudinal effects of acetyl-L-carnitine (ALC) on patients diagnosed with Alzheimer's disease. Design: Longitudinal, double-blind, parallel-group, placebocontrolled. Setting: Twenty-four outpatient sites across the United States. Participants: A total of 334 subjects diagnosed with probable Alzheimer's disease by NINCDS-ADRDA criteria. These data were originally reported by Thal and colleagues (1996). Measurements: Cognitive subscale of the Alzheimer Disease Assessment Scale (ADAS) given every 3 months for 1 year. Results: The average rate of change was estimated using the trilinear approach, which allows for periods of both change and stability. Both the ALC group and the placebo group exhibited the same mean rate of change on the ADAS (0.68 points/month). However, a multiple regression analysis revealed a statistically significant Age × Drug interaction characterized by younger subjects benefiting more from ALC treatment than older subjects. Further analyses suggested that the optimal, though not statistically significant, cutpoint for ALC benefit was 61 years of age. Conclusions: ALC slows the progression of Alzheimer's disease in younger subjects, and the use of the trilinear approach to estimate the average rate of change may prove valuable in pharmacological trials.

Download Full-text

Uroflowmetry in bladder outflow obstruction evaluating sensitivity and specificity - A clinical study

KYAMC Journal ◽

10.3329/kyamcj.v1i1.13303 ◽

2013 ◽

Vol 1 (1) ◽

pp. 24-26

Author(s):

Ashraf Uddin Mallik

Keyword(s):

Clinical Study ◽

Sensitivity And Specificity ◽

Outflow Obstruction ◽

Bladder Outflow Obstruction

DOI: http://dx.doi.org/10.3329/kyamcj.v1i1.13303KYAMC Journal Vol.1(1) July 2010, 24-26

Download Full-text

Comparison of Deep Neural Network Models and Effectiveness of EMG Signal Feature Value for Estimating Dorsiflexion

Electronics ◽

10.3390/electronics10222767 ◽

2021 ◽

Vol 10 (22) ◽

pp. 2767

Author(s):

Muhammad Akmal Bin Mohammed Zaffir ◽

Praveen Nuwantha ◽

Daiki Arase ◽

Keiko Sakurai ◽

Hiroki Tamura

Keyword(s):

Neural Network ◽

Average Rate ◽

Network Models ◽

Rate Of Change ◽

Estimation Accuracy ◽

Neural Network Models ◽

Emg Signal ◽

Minimum Number ◽

Deep Learning Network ◽

Simple Network

(1) Background: Robotic ankle–foot orthoses (AFO) are often used for gait rehabilitation. Our research focuses on the design and development of a robotic AFO with minimum number of sensor inputs. However, this leads to degradation of gait estimation accuracy. (2) Methods: To prevent degradation of accuracy, we compared a few neural network models in order to determine the best network when only two input channels are being used. Further, the EMG signal feature value of average rate of change was used as input. (3) Results: LSTM showed the highest accuracy. However, MLP with a small number of hidden layers showed results similar to LSTM. Moreover, the accuracy for all models, with the exception of LSTM for one subject (SD), increased with the addition of feature value (average rate of change) as input. (4) Conclusions: In conclusion, time-series networks work best with a small number of sensor inputs. However, depending on the optimizer being used, even a simple network can outrun a deep learning network. Furthermore, our results show that applying EMG signal feature value as an input tends to increase the estimation accuracy of the network.

Download Full-text

Holmium laser enucleation of the prostate (HOLEP) is superior to TURP for the relief of bladder outflow obstruction (BOO): A randomised trial with two year follow up

European Urology Supplements ◽

10.1016/s1569-9056(03)80409-8 ◽

2003 ◽

Vol 2 (1) ◽

pp. 103

Author(s):

P. Gilling ◽

K. Kennett ◽

A. Westenberg ◽

M. Fraundorfer

Keyword(s):

Randomised Trial ◽

Holmium Laser ◽

Outflow Obstruction ◽

Bladder Outflow Obstruction ◽

Laser Enucleation ◽

Holmium Laser Enucleation

Download Full-text

Factors affecting radiotherapy prescribing patterns in the post-mastectomy setting

Current Oncology ◽

10.3747/co.25.3773 ◽

2018 ◽

Vol 25 (2) ◽

pp. 146 ◽

Cited By ~ 2

Author(s):

T.A. Koulis ◽

A. Dang ◽

C. Speers ◽

R.A. Olson

Keyword(s):

Breast Cancer ◽

Background Radiation ◽

Prescribing Patterns ◽

Autologous Reconstruction ◽

Breast Cancer Patients ◽

Prescribing Practices ◽

Curative Intent ◽

Factors Affecting ◽

Treatment Information ◽

Treatment Centre

Background Radiation therapy (rt) after mastectomy for breast cancer can improve survival outcomes, but has been associated with inferior cosmesis after breast reconstruction. In the literature, rt dose and fractionation schedules are inconsistently reported. We sought to determine the pattern of rt prescribing practices in a provincial rt program for patients treated with mastectomy and reconstruction.Methods Women diagnosed with stages 0–iii breast cancer between January 2012 and December 2013 and treated with curative-intent rt were identified from a clinicopathology database. Patient demographic, tumour, and treatment information were extracted. Of the identified patients, those undergoing mastectomy were the focus of the present analysis.Results Of 4016 patients identified, 1143 (28%) underwent mastectomy. The patients treated with mastectomy had a median age of 57 years, and 37% of them underwent reconstruction. Treatment with more than 16 fractions of rt was associated with autologous reconstruction [odds ratio (or): 37.2; 95% confidence interval (ci): 11.2 to 123.7; p < 0.001], implant reconstruction (or: 93.3; 95% ci: 45.3 to 192.2; p < 0.001), and treating centre. Hypofractionated treatment was associated with older age (or: 0.94; 95% ci: 0.92 to 0.96; p < 0.001), and living more than 400 km from a treatment centre (or: 0.37; 95% ci: 0.16 to 0.86; p = 0.02).Conclusions Prescribing practices in breast cancer patients undergoing mastectomy are influenced by reconstruction intent, age, nodal status, and distance from the treatment centre. Those factors should be considered when making treatment decisions.

Download Full-text