scholarly journals Health status classification model for medical adherence system in retirement township

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1065
Author(s):  
Abubaker Faisal Abubaker Sherif ◽  
Wooi Haw Tan ◽  
Chee Pun Ooi ◽  
Yi Fei Tan

Medical adherence and remote patient monitoring have gained huge attention from researchers recently, especially with the need to observe the patients’ health outside hospitals due to the ongoing pandemic. The main goal of this research work is to propose a health status classification model that provides a numerical indicator of the overall health condition of a patient via four major vital signs, which are body temperature, blood pressure, blood oxygen saturation level, and heart rate. A dataset has been prepared based on the data obtained from hospital records, with these four vital signs extracted for each patient. This dataset provides a label associating each patient to the number of medical diagnoses. Generally, the number of diagnoses correlates with the patient's medical condition, with no diagnoses indicating normal condition, one to two diagnoses suggest low risk, and more than that implies high risk. Thus, we propose a method to classify a patient’s health status into three classes, which are normal, low risk and high risk. This would provide guidance for healthcare workers on the patient's medical condition. By training the classification model using the prepared dataset, the seriousness of a patient's health condition can be predicted. This prediction is performed by classifying the patients based on their four vital signs. Our tests have yielded encouraging results using precision and recall as the evaluation metrics. The key outcome of this work is a trained classification model that quantifies a patient's health condition based on four vital signs. Nevertheless, the model can be further improved by considering more input features such as medical history. The results obtained from this research can assist medical personnel by providing a secondary advice regarding the health status for the patients who are located remotely from the medical facilities.

2020 ◽  
Author(s):  
Mo Chen ◽  
Tian-en Li ◽  
Pei-zhun Du ◽  
Junjie Pan ◽  
Zheng Wang ◽  
...  

Abstract Background and aims: In this research, we aimed to construct a risk classification model to predict overall survival (OS) and locoregional surgery benefit in colorectal cancer (CRC) patients with distant metastasis.Methods: We selected a cohort consisting of 12741 CRC patients diagnosed with distant metastasis between 2010 and 2014, from the Surveillance, Epidemiology and End Results (SEER) database. Patients were randomly assigned into training group and validation group at the ratio of 2:1. Univariable and multivariable Cox regression models were applied to screen independent prognostic factors. A nomogram was constructed and assessed by the Harrell’s concordance index (C-index) and calibration plots. A novel risk classification model was further established based on the nomogram.Results: Ultimately 12 independent risk factors including race, age, marriage, tumor site, tumor size, grade, T stage, N stage, bone metastasis, brain metastasis, lung metastasis and liver metastasis were identified and adopted in the nomogram. The C-indexes of training and validation groups were 0.77 (95% confidence interval [CI] 0.73-0.81) and 0.75 (95% CI 0.72-0.78), respectively. The risk classification model stratified patients into three risk groups (low-, intermediate- and high-risk) with divergent median OS (low-risk: 36.0 months, 95% CI 34.1-37.9; intermediate-risk: 18.0 months, 95% CI 17.4-18.6; high-risk: 6.0 months, 95% CI 5.3-6.7). Locoregional therapies including surgery and radiotherapy could prognostically benefit patients in the low-risk group (surgery: hazard ratio [HR] 0.59, 95% CI 0.50-0.71; radiotherapy: HR 0.84, 95% CI 0.72-0.98) and intermediate risk group (surgery: HR 0.61, 95% CI 0.54-0.68; radiotherapy: HR 0.86, 95% CI 0.77-0.95), but not in the high-risk group (surgery: HR 1.03, 95% CI 0.82-1.29; radiotherapy: HR 1.03, 95% CI 0.81-1.31). And all risk groups could benefit from systemic therapy (low-risk: HR 0.68, 95% CI 0.58-0.80; intermediate-risk: HR 0.50, 95% CI 0.47-0.54; high-risk: HR 0.46, 95% CI 0.40-0.53).Conclusion: A novel risk classification model predicting prognosis and locoregional surgery benefit of CRC patients with distant metastasis was established and validated. This predictive model could be further utilized by physicians and be of great significance for medical practice.


2020 ◽  
Vol 8 (4) ◽  
pp. 93-98
Author(s):  
Natalia Fomina ◽  
Grigory Chernyavsky ◽  
Julia Melnikova ◽  
Olga Aleshina

The purpose of the study is to assess the health status of the 1st – 4th year students in the Department of Drama using the G. Apanasenko method. The somatic health condition determines the incidence of diseases, the performance of students, and their future vocational opportunities. Monitoring the condition of students is an important component of the physical education system implemented at the universities of theater studies in the framework of "Physical education" and "Stage movement" disciplines. Methods and organization of research. The paper presents the results of the survey (September 2020) covering 43 students aged 17-21 years (25 boys and 18 girls) using the G. Apanasenko express method of assessing health condition. The authors measured main vital signs (body length and weight, heart rate, blood pressure, VC, EPOC, post-exercise recovery period) and obtained overall assessment of health condition of each student and its individual indices (mass, vital, strength, Robinson). Research results and their discussion. The research revealed that 53.5% of students have average level of health indicator. However, only 51.2% of indicators fall within the zone of healthy values, while the remaining 48.8% stay below the safe limit. The indicators of 61.1% of girls are in the safe zone, while only 44% of boys fall within this segment. There is a decrease in health indicators of students by the 4th year of study, which is the result of a decrease in their sport activities due to the lack of "Physical education" and "Stage movement" special disciplines. Analysis of the calculated indices highlighted the challenging components of the overall health assessment. Power index provided the lowest indicators. Girls have higher indicator values than boys, as well as the life index indicators. Conclusion. The revealed facts contribute to determination of the direction of further research aimed at the refinement of educational programs on physical education and stage movement.


2021 ◽  
Vol 5 (3) ◽  
pp. 99-103
Author(s):  
Qurratul Ain Rizvi ◽  
◽  
Aisha Jamal ◽  
Naveena Fatima ◽  
Munira Borhany ◽  
...  

Abstract: Background: The incidence of neutropenia in hematological malignancies comprises of huge burden of febrile neutropenia. Multinational Association of Supportive Care in Cancer (MASCC) risk index score is the most widely used model for forecast of complications. Objective: The aim of this study was to determine diagnostic accuracy of MASCC scoring system in febrile neutropenia patients suffering from hematological disorders. Materials & Methods: Patients suffering from hematological disorders and presenting with febrile neutropenia were stratified into low and high risk groups according to MASSC score. The standard score range from 0 to 26 points; score of more than or equals to 21 were considered to be low risk and score of less than 21 was high-risk category. As an in-patient at National Institute of Blood Disease & Bone Marrow Transplantation, they were followed over the course of illness for development of any serious medical condition until resolution of febrile neutropenia. Results: Of 217 patients, serious medical conditions were documented in (63%) of individuals among the high-risk group cohort and (13%) developed serious medical conditions in low-risk cohort. Major disease encountered was acute leukemia (69%). Hypotension 14 (22.2%) and hepatic failure 14 (22.2%) were among the two most common variables of established serious medical condition. The overall sensitivity and specificity of MASCC score was 69.8% and 81.8%, with the positive and negative predictive value of 61.1% and 86.8% respectively. Conclusion: The score has been re-validated in this study and determined its significance in ascertainment of high-risk cohort among febrile neutropenic patients in the current era, thereby helping the physicians to tailor the management approach accordingly. Keywords: MASCC, Febrile neutropenia, Leukemia, Hematological disorders, Cytotoxic chemotherapy.


2021 ◽  
Author(s):  
Mohammad A. Dabbah ◽  
Angus B. Reed ◽  
Adam T.C. Booth ◽  
Arrash Yassaee ◽  
Alex Despotovic ◽  
...  

Abstract The COVID-19 pandemic has created an urgent need for robust, scalable monitoring tools supporting stratification of high-risk patients. This research aims to develop and validate prediction models, using the UK Biobank, to estimate COVID-19 mortality risk in confirmed cases. From the 11,245 participants testing positive for COVID-19, we develop a data-driven random forest classification model with excellent performance (AUC: 0.91), using baseline characteristics, pre-existing conditions, symptoms, and vital signs, such that the score could dynamically assess mortality risk with disease deterioration. We also identify several significant novel predictors of COVID-19 mortality with equivalent or greater predictive value than established high-risk comorbidities, such as detailed anthropometrics and prior acute kidney failure, urinary tract infection, and pneumonias. The model design and feature selection enables utility in outpatient settings. Possible applications include supporting individual-level risk profiling and monitoring disease progression across patients with COVID-19 at-scale, especially in hospital-at-home settings.


2019 ◽  
Author(s):  
Wei Jiang ◽  
Sauleh Siddiqui ◽  
Diego Martinez ◽  
Stephanie Cabral ◽  
Matthew Toerper ◽  
...  

BACKGROUND Patients hospitalized with heart failure suffer the highest rates of 30-day readmission among any clinically-defined patient populations in the United States. Investigation into the predictability of 30-day readmissions can lead to clinical decision-support tools and targeted interventions that can help care providers to improve individual patient care and reduce readmission risk. OBJECTIVE We developed a dynamic readmission risk prediction model that yields daily predictions for hospitalized heart failure patients toward identifying risk trajectories over time. We identified clinical predictors associated with different patterns in readmission risk trajectories. METHODS A two-stage predictive modeling approach combining logistic and beta regression was applied to electronic health record (EHR) data accumulated daily to predict 30-day readmission for a cohort of 534 heart failure patient encounters over 2,750 patient-days. Unsupervised clustering was performed on predictions to uncover time-dependent trends in readmission risk over the patient’s hospital stay. RESULTS Readmission occurred in 107 (20.0%) encounters. The out-of-sample AUC for the two-stage predictive model was 0.73 (±0.08). Dynamic clinical predictors capturing lab results and vital signs had the highest predictive value compared to demographic, administrative, medication and procedural data included. Unsupervised clustering identified four risk trajectory groups: decreasing risk (24.5% encounters), high risk (21.2%), moderate risk (33.1%), and low risk (21.2%). The decreasing risk group demonstrated change in average probability of readmission from admission (0.69) to discharge (0.30), while the high risk (0.75), moderate risk (0.61), and low risk (0.39) maintained consistency over the hospital course. Clinical predictors that discriminated groups included lab measures (hemoglobin, potassium, sodium), vital signs (diastolic blood pressure), and the number of prior hospitalizations. CONCLUSIONS Dynamically predicting readmission and quantifying trends over patients’ hospital stay illuminated differing risk trajectory groups. Identifying risk trajectory patterns and distinguishing predictors may shed new light on indicators of readmission and the isolated effects of the index hospitalization.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohammad A. Dabbah ◽  
Angus B. Reed ◽  
Adam T. C. Booth ◽  
Arrash Yassaee ◽  
Aleksa Despotovic ◽  
...  

AbstractThe COVID-19 pandemic has created an urgent need for robust, scalable monitoring tools supporting stratification of high-risk patients. This research aims to develop and validate prediction models, using the UK Biobank, to estimate COVID-19 mortality risk in confirmed cases. From the 11,245 participants testing positive for COVID-19, we develop a data-driven random forest classification model with excellent performance (AUC: 0.91), using baseline characteristics, pre-existing conditions, symptoms, and vital signs, such that the score could dynamically assess mortality risk with disease deterioration. We also identify several significant novel predictors of COVID-19 mortality with equivalent or greater predictive value than established high-risk comorbidities, such as detailed anthropometrics and prior acute kidney failure, urinary tract infection, and pneumonias. The model design and feature selection enables utility in outpatient settings. Possible applications include supporting individual-level risk profiling and monitoring disease progression across patients with COVID-19 at-scale, especially in hospital-at-home settings.


2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Wajid Shah ◽  
Muhammad Aleem ◽  
Muhammad Azhar Iqbal ◽  
Muhammad Arshad Islam ◽  
Usman Ahmed ◽  
...  

Cardiovascular and chronic respiratory diseases are global threats to public health and cause approximately 19 million deaths worldwide annually. This high mortality rate can be reduced with the use of technological advancements in medical science that can facilitate continuous monitoring of physiological parameters—blood pressure, cholesterol levels, blood glucose, etc. The futuristic values of these critical physiological or vital sign parameters not only enable in-time assistance from medical experts and caregivers but also help patients manage their health status by receiving relevant regular alerts/advice from healthcare practitioners. In this study, we propose a machine-learning-based prediction and classification system to determine futuristic values of related vital signs for both cardiovascular and chronic respiratory diseases. Based on the prediction of futuristic values, the proposed system can classify patients’ health status to alarm the caregivers and medical experts. In this machine-learning-based prediction and classification model, we have used a real vital sign dataset. To predict the next 1–3 minutes of vital sign values, several regression techniques (i.e., linear regression and polynomial regression of degrees 2, 3, and 4) have been tested. For caregivers, a 60-second prediction and to facilitate emergency medical assistance, a 3-minute prediction of vital signs is used. Based on the predicted vital signs values, the patient’s overall health is assessed using three machine learning classifiers, i.e., Support Vector Machine (SVM), Naive Bayes, and Decision Tree. Our results show that the Decision Tree can correctly classify a patient’s health status based on abnormal vital sign values and is helpful in timely medical care to the patients.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 63-68
Author(s):  
Schweizer ◽  
Seifert ◽  
Gemsenjäger

Fragestellung: Die Bedeutung von Lymphknotenbefall bei papillärem Schilddrüsenkarzinom und die optimale Lymphknotenchirurgie werden kontrovers beurteilt. Methodik: Retrospektive Langzeitstudie eines Operateurs (n = 159), prospektive Dokumentation, Nachkontrolle 1-27 (x = 8) Jahre, Untersuchung mit Bezug auf Lymphknotenbefall. Resultate: Staging. Bei 42 Patienten wurde wegen makroskopischem Lymphknotenbefall (cN1) eine therapeutische Lymphadenektomie durchgeführt, mit pN1 Status bei 41 (98%) Patienten. Unter 117 Patienten ohne Anhalt für Lymphknotenbefall (cN0) fand sich okkulter Befall bei 5/29 (17%) Patienten mit elektiver (prophylaktischer) Lymphadenektomie, und bei 2/88 (2.3%) Patienten ohne Lymphadenektomie (metachroner Befall) (p < 0.005). Lymphknotenrezidive traten (1-5 Jahre nach kurativer Primärtherapie) bei 5/42 (12%) pN1 und bei 3/114 (2.6%) cN0, pN0 Tumoren auf (p = 0009). Das 20-Jahres-Überleben war bei TNM I + II (low risk) Patienten 100%, d.h. unabhängig vom N Status; pN1 vs. pN0, cN0 beeinflusste das Überleben ungünstig bei high risk (>= 45-jährige) Patienten (50% vs. 86%; p = 0.03). Diskussion: Der makroskopische intraoperative Lymphknotenbefund (cN) hat Bedeutung: - Befall ist meistens richtig positiv (pN1) und erfordert eine ausreichend radikale, d.h. systematische, kompartiment-orientierte Lymphadenektomie (Mikrodissektion) zur Verhütung von - kurablem oder gefährlichem - Rezidiv. - Okkulter Befall bei unauffälligen Lymphknoten führt selten zum klinischen Rezidiv und beeinflusst das Überleben nicht. Wir empfehlen eine weniger radikale (sampling), nur zentrale prophylaktische Lymphadenektomie, ohne Risiko von chirurgischer Morbidität. Ein empfindlicherer Nachweis von okkultem Befund (Immunhistochemie, Schnellschnitt von sampling Gewebe oder sentinel nodes) erscheint nicht rational. Bei pN0, cN0 Befund kommen Verzicht auf 131I Prophylaxe und eine weniger intensive Nachsorge in Frage.


2017 ◽  
Vol 29 (4) ◽  
pp. 382-393 ◽  
Author(s):  
Tracy K. Witte ◽  
Jill M. Holm-Denoma ◽  
Kelly L. Zuromski ◽  
Jami M. Gauthier ◽  
John Ruscio
Keyword(s):  

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