scholarly journals Early prediction of the risk of scoring lower than 500 on the COMLEX 1

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Zhong ◽  
Han Wang ◽  
Payton Christensen ◽  
Kevin McNeil ◽  
Matthew Linton ◽  
...  
Keyword(s):  
At Risk ◽  
Logistic Regression ◽  
Medical Students ◽  
Student Performance ◽  
Predictive Models ◽  
Pearson Correlation ◽  
Significant Risk ◽  
The United States ◽  
Odds Ratios ◽  
College Of Osteopathic Medicine

Abstract Background The Comprehensive Osteopathic Medical Licensing Examination of the United States Level 1 (COMLEX 1) is important for medical students to be able to graduate. There is a glaring need to identify students who are at a significant risk of performing poorly on COMLEX 1 as early as possible so that extra assistance can be provided to those students. Our goal is to produce a reliable predictive model to identify students who are at risk of scoring lower than 500 on COMLEX 1 at the earliest possible time. Methods Academic data from medical students who matriculated at Rocky Vista University College of Osteopathic Medicine between 2011 and 2017 were obtained. Odds ratios were used to assess the predictors for scoring lower than 500 on COMLEX 1. Correlation with COMLEX 1 scores was assessed with Pearson correlation coefficient. The predictive models were developed by multiple logistic regression, backward logistic regression, and logistic regression with average scores in courses in the first three semesters, and were based on performances on the Medical College Admissions Test (MCAT) before admission, as well as students’ performances in preclinical courses during the first three semesters. The models were generated in about 82% of the student performance data and were then validated in the remaining 18% of the data. Results Odds ratios showed that MCAT scores and final grades in each course in the first three semesters were significant in predicting a score lower than 500 on COMLEX 1. Performances in third-semester courses including Renal System II, Cardiovascular System II, and Respiratory System II were most important in prediction. The three predictive models had sensitivities of 65.8 -71%, and specificities of 83.2 - 88.2% in predicting a score lower than 500 on COMLEX 1. Conclusions Lower MCAT scores and lower grades in the first three semesters of medical school predict scoring lower than 500 on COMLEX 1. Students who are identified at risk by our models will have a 65.8 -71% chance of actually scoring lower than 500 on COMLEX 1. Those students will have enough time to receive assistance before taking COMLEX 1.

Workplace violence against physicians and medical students in west part of Iran

2019 ◽  
Vol 12 (2) ◽  
pp. 116-123 ◽  
Author(s):  
Abdorrahim Afkhamzadeh ◽  
Amjad Mohamadi Bolbanabad ◽  
Bayan Moloudi ◽  
Hossein Safari ◽  
Bakhtiar Piroozi
Keyword(s):  
Logistic Regression ◽  
Medical Students ◽  
Workplace Violence ◽  
Physical Violence ◽  
Significant Risk ◽  
Verbal Abuse ◽  
Teaching Hospitals ◽  
Related Factors ◽  
Cross Sectional ◽  
Content Type

Purpose The purpose of this paper is to survey the prevalence of exposure to workplace violence (WPV) including physical violence, verbal abuse, bullying as well as its related factors among physicians and medical students attending teaching hospitals of Kurdistan University of Medical Sciences (KUMS). Design/methodology/approach This is a descriptive analytic as well as a cross-sectional study which was carried out on all physicians (general and specialists) and medical students attending teaching hospitals of KUMS in 2014. Overall, 400 participated in this study and data were gathered using a standard questionnaire. Then, data were analyzed using SPSS 20, χ2 and Fisher’s exact tests as well as univariate and adjusted logistic regression. Findings The prevalence of physical violence, verbal abuse and bullying among medical students was reported 4.5, 59 and 0.8 percent, respectively. In addition, the prevalence of these violence among general practitioners was 6.9, 72.4 and 0 percent, respectively. Moreover, 11.5, 42.3 and 3.8 percent of specialists had experienced physical violence, verbal abuse and bullying, respectively. Patients and their relatives were the main sources of the violence. Based on the results of multivariate logistic regression, male sex (AOR=2.60, CI: 1.56–4.32) and having shift work (AOR=3.13, CI: 1.67–5.84) were the most significant risk factors for total WPV. Originality/value The WPV experienced by physicians and medical students attending teaching hospitals of MUK is high. Health sector authorities should develop and implement proper strategies and interventions aiming at reducing or preventing from incidence of WPV.

scholarly journals Association between cumulative serum urate and development of diabetes type II: the Kailuan Study

2019 ◽  
Vol 39 (2) ◽  
pp. 339-346
Author(s):  
Yixuan Han ◽  
Yanying Liu ◽  
Xuejun Liu ◽  
Wenhao Yang ◽  
Ping Yu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Serum Urate ◽  
Diabetes Type ◽  
Cumulative Exposure ◽  
Type Ii ◽  
Odds Ratios ◽  
Diabetes Type Ii

Abstract Objective To explore whether cumulative serum urate (cumSU) is correlated with diabetes type II mellitus incidence. Methods In this study, we recruited individuals participating in all Kailuan health examinations from 2006 to 2013 without stroke, cancer, gestation, myocardial infarction, and diabetes type II diagnosis in the first three examinations. CumSU was calculated by multiplying the average serum urate concentration and the time between the two examinations (umol/L × year). CumSU levels were categorized into five groups: Q1–Q5. The effect of cumSU on diabetes type II incidence was estimated by logistic regression. Results A total of 36,277 individuals (27,077 men and 9200 women) participated in the final analysis. The multivariate logistic regression model showed the odds ratios (95% confidence intervals) of diabetes type II from Q1 to Q5 were 1.00 (reference), 1.25 (1.00 to 1.56), 1.43 (1.15 to 1.79), 1.49 (1.18 to 1.87), and 1.80 (1.40 to 2.32), respectively. Multivariable odds ratios per 1-standard deviation increase in cumSU were 1.26 (1.17 to 1.37) in all populations, 1.20 (1.10 to 1.32) for men, and 1.52 (1.27 to 1.81) for women, respectively. Conclusions CumSU is a significant risk factor for diabetes type II. Individuals with higher cumSU, especially women, are at a higher risk of diabetes type II independent of other known risk factors.Key Points• Cumulative exposure to serum urate is a significant risk factor for diabetes type II.• Individuals with higher cumSU, especially women, are at a higher risk of diabetes type II.

scholarly journals Curriculum Initiatives to Enhance Research Skills Acquisition by Medical Students: A Scoping Review of the Literature

2021 ◽  
Author(s):  
Crea Carberry ◽  
Geoff McCombe ◽  
Helen Tobin ◽  
Diarmuid Stokes ◽  
Jason Last ◽  
...  
Keyword(s):  
Medical Students ◽  
Student Performance ◽  
Scoping Review ◽  
Research Output ◽  
The United States ◽  
Skills Acquisition ◽  
Research Activity ◽  
Research Skills ◽  
Medical Degree ◽  
Intercalated Degree

Abstract Background: Although it is accepted that providing medical students with opportunities to engage in research activity is beneficial, little data has been collated on how medical degree curricula may address this issue. This review aims to address this knowledge gap by conducting a scoping review examining curriculum initiatives that seek to enhance research experience for medical students.Methods: This review looks to specifically look at ’doing research’ as defined by the MEDINE 2 consensus rather than ‘using research’ for the bachelor component of the Bologna Cycle. The five-stage framework developed by Arksey & O’Malley was utilised.Results: Ultimately, 120 articles were included in this scoping review; 26 related to intercalated degree options and 94 to non-intercalated degree options. Research initiatives from the United States were most featured (53/120 articles). For non-intercalated research options, mandatory and elective research projects predominated. The included studies were heterogeneous in their methodology. The main outcomes reported were student research output, description of the curriculum initiative(s) and self-reported research skills acquisition. For the intercalated degree options, the three main findings were descriptions of more ‘novel’ intercalated degree options than the traditional BSc, student perspectives on intercalating and the effect of intercalating on medical student performance and careers. Conclusion: There are a number of options available to faculty involved in planning medical degree programmes but further research is needed to determine whether research activity should be optional or mandatory. For now, flexibility is probably appropriate depending on a medical school’s resources, curriculum, educational culture and population needs.

scholarly journals Machine Learning Can Predict Deaths in Patients with Diverticulitis During their Hospital Stay

2020 ◽  
Author(s):  
Fahad Shabbir Ahmed ◽  
Raza-Ul-Mustafa ◽  
Liaqat Ali ◽  
Imad-ud-Deen ◽  
Tahir Hameed ◽  
...  
Keyword(s):  
Neural Network ◽  
Machine Learning ◽  
Risk Factors ◽  
At Risk ◽  
Logistic Regression ◽  
Deep Neural Network ◽  
Statistical Significance ◽  
Significant Risk ◽  
Premature Death ◽  
Second Phase

ABSTRACTIntroductionDiverticulitis is the inflammation and/or infection of small pouches known as diverticula that develop along the walls of the intestines. Patients with diverticulitis are at risk of mortality as high as 17% with abscess formation and 45% with secondary perforation, especially patients that get admitted to the inpatient services are at risk of complications including mortality. We developed a deep neural networks (DNN) based machine learning framework that could predict premature death in patients that are admitted with diverticulitis using electronic health records (EHR) to calculate the statistically significant risk factors first and then to apply deep neural network.MethodsOur proposed framework (Deep FLAIM) is a two-phase hybrid works framework. In the first phase, we used National In-patient Sample 2014 dataset to extract patients with diverticulitis patients with and without hemorrhage with the ICD-9 codes 562.11 and 562.13 respectively and analyzed these patients for different risk factors for statistical significance with univariate and multivariate analyses to generate hazard ratios, to rank the diverticulitis associated risk factors. In the second phase, we applied deep neural network model to predict death. Additionally, we have compared the performance of our proposed system by using the popular machine learning models such as DNN and Logistic Regression (LR).ResultsA total of 128,258 patients were used, we tested 64 different variables for using univariate and multivariate (age, gender and ethnicity) cox-regression for significance only 16 factors were statistically significant for both univariate and multivariate analysis. The mortality prediction for our DNN out-performed the conventional machine learning (logistic regression) in terms of AUC (0.977 vs 0.904), training accuracy (0.931 vs 0.900), testing accuracy (0.930 vs 0.910), sensitivity (90% vs 88%) and specificity (95% vs 93%).ConclusionOur Deep FLAIM Framework can predict mortality in patients admitted to the hospital with diverticulitis with high accuracy. The proposed framework can be expanded to predict premature death for other disease.

scholarly journals Factors That Explain Differences in Abstinence Between Black and White Smokers: A Prospective Intervention Study

2019 ◽  
Vol 111 (10) ◽  
pp. 1078-1087 ◽  
Author(s):  
Nicole L Nollen ◽  
Matthew S Mayo ◽  
Lisa Sanderson Cox ◽  
Neal L Benowitz ◽  
Rachel F Tyndale ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Low Income ◽  
Home Ownership ◽  
Statistical Tests ◽  
The United States ◽  
Smoking Abstinence ◽  
Odds Ratios ◽  
Race Difference ◽  
Neighborhood Problems ◽  
Blacks And Whites

Abstract Background Black-white differences in smoking abstinence are not well understood. This trial sought to confirm previously reported differences in quitting between blacks and whites and to identify factors underlying this difference. Methods During enrollment, 224 black and 225 white low-income smokers were stratified on race and within race on age and sex to ensure balance on these factors known to impact abstinence. The intervention included varenicline for 12 weeks and six guideline-based smoking cessation counseling sessions. The primary endpoint was cotinine-verified 7-day point prevalence smoking abstinence at week 26. A priori socioeconomic, smoking, treatment process (eg, treatment utilization, side effects, withdrawal relief), psychosocial, and biological factors were assessed to investigate race differences in abstinence. Unadjusted odds ratios (OR) were used to compare abstinence between blacks and whites. Adjusted odds ratios from logistic regression models were used to examine predictors of abstinence. All statistical tests were two-sided. Results Blacks were less likely to achieve abstinence at week 26 (14.3% vs 24.4%, OR = 0.51, 95% confidence interval [CI] = 0.32 to 0.83, P = .007). Utilizing best subsets logistic regression, five factors associated with race jointly predicted abstinence: home ownership (yes/no, OR = 3.03, 95% CI = 1.72 to 5.35, P < .001), study visits completed (range = 0–6, OR = 2.81, 95% CI = 1.88 to 4.20, P < .001), income (household member/$1000, OR = 1.03, 95% CI = 1.01 to 1.06, P = .02), plasma cotinine (per 1 ng/mL, OR = 0.997, 95% CI = 0.994 to 0.999, P = .002), and neighborhood problems (range = 10–30, OR = 0.88, 95% CI = 0.81 to 0.96, P = .003). Conclusions The race difference in abstinence was fully explained by lack of home ownership, lower income, greater neighborhood problems, higher baseline cotinine, and higher visit completion, which were disproportionately represented among blacks. Findings illuminate factors that make it harder for blacks in the United States to quit smoking relative to whites and provide important areas for future studies to reduce tobacco-related health disparities.

scholarly journals Retrospective cross sectional analysis of demographic disparities in outcomes of CPR performed by EMS providers in the United States

2021 ◽  
Vol 10 ◽  
pp. 204800402110006
Author(s):  
Tess Hill ◽  
Thomas Weber ◽  
Marshall Roberts ◽  
Hernando Garzon ◽  
Alvaro Fraga ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiopulmonary Arrest ◽  
The United States ◽  
Spontaneous Circulation ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Entire Cohort ◽  
Emergency Medical ◽  
Service Information ◽  
Gender And Age

Objective To investigate demographic disparities in prehospital cardiopulmonary resuscitation (CPR) initiation and successful outcomes of patients with out-of-hospital cardiac arrest (OHCA) treated by emergency medical services (EMS) providers. Methods We analyzed the National Emergency Medical Service Information Systems (NEMSIS) 2017 database, analyzing patient gender, age and race against CPR initiation and Return of Spontaneous Circulation (ROSC). The analysis was performed for a subset of patients who received bystander interventions (n = 3,362), then repeated for the whole cohort of patients (n = 5,833). Results Within the subgroup of patients that received CPR or AED application prior to the arrival of the paramedics, a logistic regression for CPR initiation rates as a function of race, gender and age reported the following adjusted odds ratios: African American (AA) to White 0.570 (95%CI [0.419, 0.775]), Hispanic to White 0.735 (95%CI [0.470, 1.150]); female to male 0.768 (95%CI [0.598, 0.986]); senior to adult 0.708 (95%CI [0.545, 0.920). Similarly, a logistic regression of ROSC as a function of race, gender and age reported the following adjusted odds ratios: AA to White 0.652 (95%CI [0.533, 0.797]) Hispanic to White 1.018 (95%CI [0.783, 1.323]); female to male 0.887 (95%CI [0.767, 1.025]); senior to adult 0.817 (95%CI [0.709, 0.940]). Similar trends existed in the entire cohort of patients. Conclusions These results suggest that there are discrepancies in patient care during cardiopulmonary arrest performed by EMS for OHCA, inviting further exploration of healthcare differences in the prehospital EMS approach to OHCA.

scholarly journals 957. Evaluation of Chagas Disease Knowledge Among Providers Caring for At-risk People with HIV

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S571-S571
Author(s):  
Jesica Hayon ◽  
Jill E Weatherhead ◽  
Eva Clark
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Medical Students ◽  
Chagas Disease ◽  
The United States ◽  
Correct Selection ◽  
Knowledge Gaps ◽  
Educational Session ◽  
The Us ◽  
Selection Of

Abstract Background Chagas disease (CD) is underdiagnosed in the United States due to limited healthcare provider awareness of the disease. Improving provider CD knowledge is important because &gt;200,000 people living in the US are estimated to have CD, and 20-30% of those will develop related cardiac or gastrointestinal disease. People with HIV (PWH) and CD additionally are at risk for CD reactivation, which carries a &gt;70% mortality rate. Methods The overall objective of this quality improvement project was to improve provider knowledge of CD prior to implementation of a CD screening initiative at a large HIV clinic in Houston, TX where &gt;5,000 PWH are seen annually (~60% Latinx). We administered the survey to providers at this clinic before and after a 1-hour CD educational session, which included information about CD epidemiology, risk factors, transmission, screening, diagnostic strategies, and available treatments. Results Of 33 providers who took the pre-survey (16 faculty, 14 fellows, and 3 medical students), 27 (81.8%) completed all questions. Of 21 providers who took the post-survey (12 faculty, 6 fellows, and 3 medical students), 19 (90.5%) completed all questions. We identified the following CD knowledge gaps (i.e., questions initially answered incorrectly by &gt;25% in the pre-educational session survey): CD transmission, regions of CD endemicity, CD risk factors, organ systems impacted by CD in PWH, and CD testing/follow-up procedures. In the post-educational session survey, we observed significant improvement in providers’ knowledge of CD epidemiology (correct selection of estimated number of people living with CD in the US improved from 26.7% to 90.5%, Fisher’s exact p&lt; 0.0001), transmission (correct selection of “mother-to-child” answer improved from 73.3% to 100%, p=0.0150), and selection of correct CD testing answers improved from 51.9% to 85%, p=0.0286. Conclusion Improved CD awareness among healthcare providers and reliable systematic screening protocols are important in at-risk populations. Through simple administration of a 1-hour educational session, we identified and improved several CD knowledge gaps. We noted significant improvement in providers’ confidence in their CD knowledge, specifically in epidemiology, transmission, and diagnostic and screening testing. Disclosures All Authors: No reported disclosures

scholarly journals Assessing Student Competencies in Antibiotic Stewardship and Patient Counseling

2020 ◽  
Vol 52 (5) ◽  
pp. 357-360
Author(s):  
Maria Teresa Santos ◽  
Sandra Oza ◽  
Zoon Naqvi ◽  
Joseph H. Grochowalski ◽  
Paul George ◽  
...  
Keyword(s):  
Medical Students ◽  
Student Performance ◽  
Communication Skills ◽  
Antibiotic Stewardship ◽  
Albert Einstein College ◽  
Albert Einstein ◽  
The United States ◽  
Contextual Knowledge ◽  
Patient Counseling ◽  
Student Competencies

Background and Objectives: Antibiotic misuse contributes to antibiotic resistance and is a growing public health threat in the United States and globally. Professional medical societies promote antibiotic stewardship education for medical students, ideally before inappropriate practice habits form. To our knowledge, no tools exist to assess medical student competency in antibiotic stewardship and the communication skills necessary to engage patients in this endeavor. The aim of this study was to develop a novel instrument to measure medical students’ communication skills and competency in antibiotic stewardship and patient counseling. Methods: We created and pilot tested a novel instrument to assess student competencies in contextual knowledge and communication skills about antibiotic stewardship with standardized patients (SP). Students from two institutions (N=178; Albert Einstein College of Medicine and Warren Alpert Medical School of Brown University) participated in an observed, structured clinical encounter during which SPs trained in the use of the instrument assessed student performance using the novel instrument. Results: In ranking examinee instrument scores, Cronbach α was 0.64 (95% CI: 0.53 to 0.74) at Einstein and 0.71 (95% CI: 0.60 to 0.79) at Brown, both within a commonly accepted range for estimating reliability. Global ratings and instrument scores were positively correlated (r=0.52, F [3, 174]=30.71, P&lt;.001), providing evidence of concurrent validity. Conclusions: Similar results at both schools supported external validity. The instrument performed reliably at both institutions under different examination conditions, providing evidence for the validity and utility of this instrument in assessing medical students’ skills related to antibiotic stewardship.

scholarly journals Urologists in cyberspace. A review of the quality of health information from American urologists’ websites using three validated tools

2013 ◽  
Vol 7 (3-4) ◽  
pp. 100-6 ◽  
Author(s):  
Lih-Ming Wong ◽  
Hanmu Yan ◽  
David Margel ◽  
Neil E. Fleshner
Keyword(s):  
Logistic Regression ◽  
Health Information ◽  
Pearson Correlation ◽  
Code Of Conduct ◽  
The United States ◽  
Census Bureau ◽  
Website Design ◽  
Quality Health ◽  
Us Census

Objectives: To evaluate a sample of urologists’ websites, based in the United States of America (USA), using three validated instruments: the Health on the Net Foundation code of conduct (HONcode), DISCERN and LIDA tools.To discuss how medical websites can be improved.   Materials and Methods: The 10 most populous cities in America , identified from the US Census Bureau, were searched using www.google.com to identify the first ten websites using the terms “urologist + city”. Each website was scored using the HONcode, DISCERN and LIDA instruments.The median score for each tool was used to dichotomize the cohort and multivariable logistic regression used to identify independent predictors of higher scores.   Results Of the 100 websites found, 78 were analysed. There were 18 academic institutions, 43 group and 17 solo practices. A medical website design service had been used by 18 websites. The HONcode badge was seen on 3 websites (4%).  Social media was used by 16 websites.Multivariable logistic regression showed predictors of higher scores for each tool were: HONcode - academic centers (OR 6.8, CI 1.2-37.3, p=0.028) and use of medical website design service (OR 17.2, CI 3.8-78.1, p=0.001);DISCERN - academic centres (OR 23.13, p=0.002, CI 3.15-169.9 and group practices (OR 7.19, p=0.022, CI 1.33-38.93). LIDA tool - there were no predictors of higher scores. Pearson correlation did not show any correlation between the three scores   Conclusions   Using 3 validated tools for appraising online health information, we found a wide variation in quality of urologists’ websites in America. Increased awareness of standards and available resources, coupled with guidance from health professional regulatory bodies, would improve the quality health information on medical websites.

scholarly journals Longitudinal Effects of Medical Students' Communication Skills on Future Performance

2015 ◽  
Vol 180 (suppl_4) ◽  
pp. 24-30 ◽  
Author(s):  
Ting Dong ◽  
Jeffrey S. LaRochelle ◽  
Steven J. Durning ◽  
Aaron Saguil ◽  
Kimberly Swygert ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Communication Skills ◽  
Clinical Skills ◽  
Pearson Correlation ◽  
Linear Regression Analysis ◽  
The United States ◽  
Evaluation Tool ◽  
Future Performance ◽  
Medical Educators

ABSTRACT Background: The Essential Elements of Communication (EEC) were developed from the Kalamazoo consensus statement on physician–patient communication. The Uniformed Services University of the Health Sciences (USU) has adopted a longitudinal curriculum to use the EEC both as a learning tool during standardized patient encounters and as an evaluation tool culminating with the end of preclerkship objective-structured clinical examinations (OSCE). Medical educators have recently emphasized the importance of teaching communication skills, as evidenced by the United States Medical Licensing Examination testing both the integrated clinical encounter (ICE) and communication and interpersonal skills (CIS) within the Step 2 Clinical Skills exam (CS). Purpose: To determine the associations between students' EEC OSCE performance at the end of the preclerkship period with later communication skills assessment and evaluation outcomes in the context of a longitudinal curriculum spanning both undergraduate medical education and graduate medical education. Methods: Retrospective data from preclerkship (overall OSCE scores and EEC OSCE scores) and clerkship outcomes (internal medicine [IM] clinical points and average clerkship National Board of Medical Examiners [NBME] scores) were collected from 167 USU medical students from the class of 2011 and compared to individual scores on the CIS and ICE components of Step 2 CS, as well as to the communication skills component of the program directors' evaluation of trainees during their postgraduate year 1 (PGY-1) residency. In addition to bivariate Pearson correlation analysis, we conducted multiple linear regression analysis to examine the predictive power of the EEC score beyond the IM clerkship clinical points and the average NBME Subject Exams score on the outcome measures. Results: The EEC score was a significant predictor of the CIS score and the PGY-1 communication skills score. Beyond the average NBME Subject Exams score and the IM clerkship clinical points, the EEC score explained an additional 13% of the variance in the Step 2 CIS score and an additional 6% of the variance in the PGY-1 communication skills score. In addition, the EEC score was more closely associated with the CIS score than the ICE score. Conclusion: The use of a standardized approach with a communication tool like the EEC can help explain future performance in communication skills independent of other education outcomes. In the context of a longitudinal curriculum, this information may better inform medical educators on learners' communication capabilities and more accurately direct future remediation efforts.

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