scholarly journals Real-world effectiveness, its predictors and onset of action of cholinesterase inhibitors and memantine in dementia: retrospective health record study

2020 ◽  
pp. 1-7
Author(s):  
Nemanja Vaci ◽  
Ivan Koychev ◽  
Chi-Hun Kim ◽  
Andrey Kormilitzin ◽  
Qiang Liu ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Real World ◽  
Care Service ◽  
Acetylcholinesterase Inhibitors ◽  
Symptomatic Treatment ◽  
Cognitive Testing ◽  
Cognitive Effect ◽  
Treatment Rate ◽  
Data Set ◽  
Medication Prescription

Background The efficacy of acetylcholinesterase inhibitors and memantine in the symptomatic treatment of Alzheimer's disease is well-established. Randomised trials have shown them to be associated with a reduction in the rate of cognitive decline. Aims To investigate the real-world effectiveness of acetylcholinesterase inhibitors and memantine for dementia-causing diseases in the largest UK observational secondary care service data-set to date. Method We extracted mentions of relevant medications and cognitive testing (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores) from de-identified patient records from two National Health Service (NHS) trusts. The 10-year changes in cognitive performance were modelled using a combination of generalised additive and linear mixed-effects modelling. Results The initial decline in MMSE and MoCA scores occurs approximately 2 years before medication is initiated. Medication prescription stabilises cognitive performance for the ensuing 2–5 months. The effect is boosted in more cognitively impaired cases at the point of medication prescription and attenuated in those taking antipsychotics. Importantly, patients who are switched between agents at least once do not experience any beneficial cognitive effect from pharmacological treatment. Conclusions This study presents one of the largest real-world examination of the efficacy of acetylcholinesterase inhibitors and memantine for symptomatic treatment of dementia. We found evidence that 68% of individuals respond to treatment with a period of cognitive stabilisation before continuing their decline at the pre-treatment rate.

scholarly journals The impact of cognitive performance on quality of life in individuals with Parkinson's disease

2016 ◽  
Vol 10 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Maira Rozenfeld Olchik ◽  
Annelise Ayres ◽  
Marcieli Ghisi ◽  
Artur Francisco Schumacher Schuh ◽  
Carlos Roberto Mello Rieder
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Poor Performance ◽  
Cognitive Testing ◽  
Cognitive Tests ◽  
Patient Consent ◽  
The Impact

ABSTRACT Background: Evidence points to the occurrence of cognitive impairment in all stages of PD, constituting a frequent and debilitating symptom, due to high impact on quality of life and mortality of patients. Objective: To correlate cognitive performance with quality of life in PD. Methods: The sample was drawn from a Movement Disorders Clinic of a reference hospital in Porto Alegre. Inclusion criteria were: PD diagnosis, according to the United Kingdom Parkinson's Disease Society Brain Bank criteria for idiopathic PD (Hughes et al. 1992) and patient consent to participate. Patients with other neurological pathologies and those submitted to deep brain stimulation were excluded. The evaluation consisted of a cognitive testing battery (composed of eight tests for assessing cognitive performance), and a questionnaire on quality of life (PDQ-39) and depression (BDI). Results: The sample comprised 85 individuals with PD, with a mean age of 62.9 years (±10.7), mean disease duration of 10.4 years (±5.7), and mean educational level of four years (±4.3). There was a significant relationship between total score on the PDQ and all cognitive tests, showing that poor cognitive performance was correlated with poor quality of life. Moreover, a significant correlation was observed between cognitive tests and depression, H&Y, education level, and age. Conclusion: It may be concluded that the individuals with PD in this sample showed a correlation between poorer quality of life and worse cognitive performance. Poor performance was also correlated with more advanced stage, older age, low level of education and depression.

scholarly journals How Does Physical Demand Affect Cognitive Performance? Interference Between Outdoor Running And Narrative Memory

2018 ◽  
Vol 62 (1) ◽  
pp. 237-241
Author(s):  
Samantha L. Epling ◽  
Graham K. Edgar ◽  
Paul N. Russell ◽  
William S. Helton
Keyword(s):  
High Risk ◽  
Task Performance ◽  
Cognitive Performance ◽  
Real World ◽  
Dual Task ◽  
Memory Task ◽  
Search And Rescue ◽  
Dual Tasking ◽  
Physical Demand ◽  
Dual Task Paradigm

Dual-tasking situations are common in military, firefighting, search and rescue, and other high risk operations. Cognitive and physical demands can occur at the same time, but little is known about the specific demands of real world tasks or how they might interfere with one another. It is well known that attempting simultaneous tasks will divide and divert attention, but to what extent? In this experiment, a narrative memory task was paired with an outdoor running task, and as expected, memory task performance declined when participants were asked to run at the same time. It is suggested that more cognitively demanding physical tasks be used within this dual-task paradigm for a better understanding of the human cognitive resource structure, i.e., how and why certain tasks interfere.

scholarly journals Identifying important nodes from content-associated heterogeneous graph by LeaderRank

2021 ◽  
Vol 2113 (1) ◽  
pp. 012082
Author(s):  
Yulong Dai ◽  
Qiyou Shen ◽  
Xiangqian Xu ◽  
Jun Yang
Keyword(s):  
Real World ◽  
Experimental Analysis ◽  
Differential Information ◽  
World Systems ◽  
Ranking Problem ◽  
Data Set ◽  
Importance Ranking ◽  
Basic Concepts ◽  
Important Nodes ◽  
Graph Nodes

Abstract Most real-world systems consist of a large number of interacting entities of many types. However, most of the current researches on systems are based on the assumption that the type of node or link in the network is unique. In other words, the network is homogeneous, containing the same type of nodes and links. Based on this assumption, differential information between nodes and edges is ignored. This paper firstly introduces the research background, challenges and significance of this research. Secondly, the basic concepts of the model are introduced. Thirdly, a novel type-sensitive LeaderRank algorithm is proposed and combined with distance rule to solve the importance ranking problem of content-associated heterogeneous graph nodes. Finally, the writer influence data set is used for experimental analysis to further prove the validity of the model.

scholarly journals Analysis on Present Mathematical Model for Predicting the Crop Production

2020 ◽  
Vol 9 (12) ◽  
pp. 168-170
Keyword(s):  
Mathematical Model ◽  
Mathematical Models ◽  
Real World ◽  
Crop Production ◽  
Ghg Emissions ◽  
Data Set ◽  
Factors Affecting ◽  
The Government ◽  
The Mathematical Model ◽  
Government Website

India is a worldwide agriculture business powerhouse. Future of agriculture-based products depends on the crop production. A mathematical model might be characterized as a lot of equations that speak to the conduct of a framework. By using mathematical model in agriculture field, we can predict the production of crop in particular area. There are various factors affecting crops such as Rainfall, GHG Emissions, Temperature, Urbanization, climate, humidity etc. A mathematical model is a simplified representation of a real-world system. It forms the system using mathematical principles in the form of a condition or a set of conditions. Suppose we need to increase the crop production, at that time the mathematical model plays a major role and our work can be easier, more significant by using the mathematical model. Through the mathematical model we predict the crop production in upcoming years. .AI, ML, IOT play a major role to predict the future of agriculture, but without mathematical models it is not possible to predict crop production accurately. To solve the real-world agriculture problem, mathematical models play a major role for accurate results. Correlation Analysis, Multiple Regression analysis and fuzzy logic simulation standards have been utilized for building a grain production benefit depending model from crop production. Prediction of crop is beneficiary to the farmer to analyze the crop management. By using the present agriculture data set which is available on the government website, we can build a mathematical model.

scholarly journals United Kingdom Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group: report 4, real-world data on the impact of deprivation on the presentation of diabetic eye disease at hospital services

2018 ◽  
Vol 103 (6) ◽  
pp. 837-843 ◽  
Author(s):  
Alastair K Denniston ◽  
Aaron Y Lee ◽  
Cecilia S Lee ◽  
David P Crabb ◽  
Clare Bailey ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Real World ◽  
Eye Disease ◽  
Inclusion Criteria ◽  
Data Set ◽  
Diabetic Eye Disease ◽  
The Impact

AimTo assess the impact of deprivation on diabetic retinopathy presentation and related treatment interventions, as observed within the UK hospital eye service.MethodsThis is a multicentre, national diabetic retinopathy database study with anonymised data extraction across 22 centres from an electronic medical record system. The following were the inclusion criteria: all patients with diabetes and a recorded, structured diabetic retinopathy grade. The minimum data set included, for baseline, age and Index of Multiple Deprivation, based on residential postcode; and for all time points, visual acuity, ETDRS grading of retinopathy and maculopathy, and interventions (laser, intravitreal therapies and surgery). The main  outcome measures were (1) visual acuity and binocular visual state, and (2) presence of sight-threatening complications and need for early treatment.Results79 775 patients met the inclusion criteria. Deprivation was associated with later presentation in patients with diabetic eye disease: the OR of being sight-impaired at entry into the hospital eye service (defined as 6/18 to better than 3/60 in the better seeing eye) was 1.29 (95% CI 1.20 to 1.39) for the most deprived decile vs 0.77 (95% CI 0.70 to 0.86) for the least deprived decile; the OR for being severely sight-impaired (3/60 or worse in the better seeing eye) was 1.17 (95% CI 0.90 to 1.55) for the most deprived decile vs 0.88 (95% CI 0.61 to 1.27) for the least deprived decile (reference=fifth decile in all cases). There is also variation in sight-threatening complications at presentation and treatment undertaken: the least deprived deciles had lower chance of having a tractional retinal detachment (OR=0.48 and 0.58 for deciles 9 and 10, 95% CI 0.24 to 0.90 and 0.29 to 1.09, respectively); in terms of accessing treatment, the rate of having a vitrectomy was lowest in the most deprived cohort (OR=0.34, 95% CI 0.19 to 0.58).ConclusionsThis large real-world study suggests that first presentation at a hospital eye clinic with visual loss or sight-threatening diabetic eye disease is associated with deprivation. These initial hospital visits represent the first opportunities to receive treatment and to formally engage with support services. Such patients are more likely to be sight-impaired or severely sight-impaired at presentation, and may need additional resources to engage with the hospital eye services over complex treatment schedules.

OP117 Digital Real-World Evidence In Times Of General Data Protection Regulation

2021 ◽  
Vol 37 (S1) ◽  
pp. 1-1
Author(s):  
Rhodri Saunders ◽  
Rafael Torrejon Torres ◽  
Maximilian Blüher
Keyword(s):  
Data Collection ◽  
Real World ◽  
Data Protection ◽  
Safety Data ◽  
Design Approach ◽  
Data Set ◽  
General Data Protection Regulation ◽  
Real World Evidence ◽  
Quality Markers ◽  
General Data

IntroductionReal-world evidence (RWE) is a useful supplement to a product's evidence base especially for medical devices, which are often unsuitable for randomized controlled trials. Generally, RWE is analyzed retrospectively (for example, healthcare records), which lack granularity for health-economic analysis. Prospective collection of RWE in hospitals can promote device-specific endpoint assessment. The advent of the General Data Protection Regulation (GDPR) requires a privacy-by-design approach. This work describes a workflow for a GDPR-compliant device-specific RWE collection as part of quality improvement initiatives (QII).MethodsA literature review identifies relevant clinical and quality markers as endpoints to the investigated technology. A panel of experts grade these endpoints on their clinical significance, privacy sensitivity, analytic value, and feasibility for collection. Endpoints meeting a predefined cut-off are considered quality markers for the QII. Finally, an RWE data collection app is designed to collect the quality markers using either longitudinal, pseudonymized data or single time-point anonymized data to ensure data protection by design.ResultsUsing this approach relevant clinical markers were identified in a GDPR-compliant manner. The data collection app design ensured that patient data were protected, while maintaining minimum requirements on patient information and consent. The pilot QII collected data on over 5,000 procedures, which represents the largest single data set available for the tested technology. Due to its prospective nature this programme was the first to collect patient outcomes in sufficient quantity for analysis, while previous studies only recorded adverse events.ConclusionsGDPR and RWE can co-exist in harmony. A design approach, which has data protection in mind from the start can combine high quality RWE collection of efficacy and safety data with maximum patient privacy.

Patterns and predictors of treatment in muscle-invasive bladder cancer (MIBC): A real-world study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16531-e16531
Author(s):  
Zengqi Lu ◽  
Jessica M. Clement ◽  
Qi Pan ◽  
Helen Swede ◽  
Rajni Mehta ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Real World ◽  
Alternative Treatment ◽  
Standard Care ◽  
Strong Predictor ◽  
Treatment Patterns ◽  
Cancer Center ◽  
Data Set ◽  
Adoption Rate ◽  
To Receive

e16531 Background: Among the approaches to curative-intent therapy for MIBC, neoadjuvant cisplatin-based chemotherapy (NAC) is recognized as the gold standard. The combined modality approach of concurrent chemo-radiation is also considered a standard of care. Despite guidelines recommending multidisciplinary care, studies have shown a low adoption rate of multidisciplinary approaches for MIBC. This study aimed to describe the treatment patterns for MIBC pts using real world data. Methods: Following the appropriate IRB approvals, investigators followed a common protocol under the auspices of the Rapid Case Ascertainment at the Yale Cancer Center. Manual chart review was performed on MIBC pts diagnosed in Connecticut from 2004 –2015 and treated at investigator-affiliated hospitals. Information on medical history, comorbidity, and treatment types were recorded. This data set was linked to the Surveillance, Epidemiology, and End Results (SEER) database for demographic information. The descriptive and logistic regression were used to analyze treatment patterns and predicators in each treatment lines: surgery alone, chemotherapy alone, radiation alone and standard care (NAC followed by surgery; surgery followed by adjuvant chemotherapy and concurrent chemo-radiation). Results: The number of adult MIBC pts in the cohort was 1,198. Among them, 290 (24.2%) received surgery as the only treatment; 117 (9.8%) received chemotherapy only; 100 (8.3%) received concurrent chemo-radiation; 96 (8.0%) received NAC followed by surgery. Besides age ( OR: 0.546, 95% CI: 0.289-0.986), when comparing female to male patients on the likelihood of receiving NAC to the alternative treatment types (radiation or surgery), female pts were less likely to receive NAC than males (OR: 0.421, 95% CI: 0.184-0.930). Conclusions: Regardless of demographics, the overall adoption rate of standard care was low, consisting of 236 pts (19.7%) of the population. From the logistic regression results, age was consistently shown as a predictor for receiving NAC over the alternative treatment types, and sex was identified as another strong predictor. Older and female patients were less likely to receive NAC than younger males.[Table: see text]

Sign in / Sign up

Export Citation Format

Share Document