scholarly journals There Is a Third Condition Aside from Survival and Death that Affects Outcome Statistics: Terminal Discharge

Author(s):  
Jianqiao Xu ◽  
Yongqiang Chen ◽  
Jiang Wang ◽  
Guixiu Yang ◽  
Peng Yan ◽  
...  

Background: Some patients discharged automatically are classified as terminal discharge, while their clinical outcome is survival, disrupting the results of clinical research. Methods: The data of this study were taken from inpatients admitted to the ICU of the First Medical Center of the People's Liberation Army General Hospital, Beijing, China from 2008-2017. We collected the data regarding medications used over the three days before discharge from the group of patients who survived and the group of patients who died, and the outcomes of all patients were recalculated by three classification algorithms (AdaBoosting, Pearson correlation coefficient, observed to expected ratio-weighted cosine similarity). Our basic assumption is that if the classification result is death but the actual in-hospital outcome is survival, the associated patient was likely terminally discharged. Results: The coincidence rate of the outcomes calculated by the AdaBoosting algorithm was 98.1%, the coincidence rate calculated by the Pearson correlation coefficient was 61.1%, and the coincidence rate calculated by the observed to expected ratio-weighted cosine similarity was 93.4%. When the three classification methods were combined, the accuracy reached 98.56%. Conclusion: The combination of clinical rules and classification methods has a synergistic effect on judgments of patients’ discharge outcomes, greatly saving time on manual retrieval and reducing the negative influence of statistics or rules.

2020 ◽  
Author(s):  
Jianqiao Xu ◽  
Yongqiang Chen ◽  
Jiang Wang ◽  
Guixiu Yang ◽  
Peng Yan ◽  
...  

Abstract Background: Some patients discharged automatically are classified as terminal discharge, while their clinical outcome is survival, disrupting the results of clinical research.Methods: The data of this study were taken from inpatients who were admitted to the ICU of the First Medical Center of the People's Liberation Army General Hospital. We collected the data regarding medications used over the three days before discharge from the group of patients who survived and the group of patients who died, and the outcomes of all patients were recalculated by three classification algorithms (AdaBoosting, Pearson correlation coefficient, observed to expected ratio-weighted cosine similarity). Our basic assumption is that if the classification result is death but the actual in-hospital outcome is survival, the associated patient was likely terminally discharged.Results: The coincidence rate of the outcomes calculated by the AdaBoosting algorithm was 98.1%, the coincidence rate calculated by the Pearson correlation coefficient was 61.1%, and the coincidence rate calculated by the observed to expected ratio-weighted cosine similarity was 93.4%. When the three classification methods were combined, the accuracy reached 98.56%.Conclusion: The combination of clinical rules and classification methods has a synergistic effect on judgments of patients’ discharge outcomes, greatly saving time on manual retrieval and reducing the negative influence of statistics or rules.


2020 ◽  
Vol 16 (1) ◽  
pp. 47-53
Author(s):  
Vicente Benavides-Córdoba ◽  
Mauricio Palacios Gómez

Introduction: Animal models have been used to understand the pathophysiology of pulmonary hypertension, to describe the mechanisms of action and to evaluate promising active ingredients. The monocrotaline-induced pulmonary hypertension model is the most used animal model. In this model, invasive and non-invasive hemodynamic variables that resemble human measurements have been used. Aim: To define if non-invasive variables can predict hemodynamic measures in the monocrotaline-induced pulmonary hypertension model. Materials and Methods: Twenty 6-week old male Wistar rats weighing between 250-300g from the bioterium of the Universidad del Valle (Cali - Colombia) were used in order to establish that the relationships between invasive and non-invasive variables are sustained in different conditions (healthy, hypertrophy and treated). The animals were organized into three groups, a control group who was given 0.9% saline solution subcutaneously (sc), a group with pulmonary hypertension induced with a single subcutaneous dose of Monocrotaline 30 mg/kg, and a group with pulmonary hypertension with 30 mg/kg of monocrotaline treated with Sildenafil. Right ventricle ejection fraction, heart rate, right ventricle systolic pressure and the extent of hypertrophy were measured. The functional relation between any two variables was evaluated by the Pearson correlation coefficient. Results: It was found that all correlations were statistically significant (p <0.01). The strongest correlation was the inverse one between the RVEF and the Fulton index (r = -0.82). The Fulton index also had a strong correlation with the RVSP (r = 0.79). The Pearson correlation coefficient between the RVEF and the RVSP was -0.81, meaning that the higher the systolic pressure in the right ventricle, the lower the ejection fraction value. Heart rate was significantly correlated to the other three variables studied, although with relatively low correlation. Conclusion: The correlations obtained in this study indicate that the parameters evaluated in the research related to experimental pulmonary hypertension correlate adequately and that the measurements that are currently made are adequate and consistent with each other, that is, they have good predictive capacity.


Sensors ◽  
2020 ◽  
Vol 21 (1) ◽  
pp. 156
Author(s):  
Charles Carlson ◽  
Vanessa-Rose Turpin ◽  
Ahmad Suliman ◽  
Carl Ade ◽  
Steve Warren ◽  
...  

Background: The goal of this work was to create a sharable dataset of heart-driven signals, including ballistocardiograms (BCGs) and time-aligned electrocardiograms (ECGs), photoplethysmograms (PPGs), and blood pressure waveforms. Methods: A custom, bed-based ballistocardiographic system is described in detail. Affiliated cardiopulmonary signals are acquired using a GE Datex CardioCap 5 patient monitor (which collects ECG and PPG data) and a Finapres Medical Systems Finometer PRO (which provides continuous reconstructed brachial artery pressure waveforms and derived cardiovascular parameters). Results: Data were collected from 40 participants, 4 of whom had been or were currently diagnosed with a heart condition at the time they enrolled in the study. An investigation revealed that features extracted from a BCG could be used to track changes in systolic blood pressure (Pearson correlation coefficient of 0.54 +/− 0.15), dP/dtmax (Pearson correlation coefficient of 0.51 +/− 0.18), and stroke volume (Pearson correlation coefficient of 0.54 +/− 0.17). Conclusion: A collection of synchronized, heart-driven signals, including BCGs, ECGs, PPGs, and blood pressure waveforms, was acquired and made publicly available. An initial study indicated that bed-based ballistocardiography can be used to track beat-to-beat changes in systolic blood pressure and stroke volume. Significance: To the best of the authors’ knowledge, no other database that includes time-aligned ECG, PPG, BCG, and continuous blood pressure data is available to the public. This dataset could be used by other researchers for algorithm testing and development in this fast-growing field of health assessment, without requiring these individuals to invest considerable time and resources into hardware development and data collection.


Water ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 82
Author(s):  
Omolola M. Adisa ◽  
Muthoni Masinde ◽  
Joel O. Botai

This study examines the (dis)similarity of two commonly used indices Standardized Precipitation Index (SPI) computed over accumulation periods 1-month, 3-month, 6-month, and 12-month (hereafter SPI-1, SPI-3, SPI-6, and SPI-12, respectively) and Effective Drought Index (EDI). The analysis is based on two drought monitoring indicators (derived from SPI and EDI), namely, the Drought Duration (DD) and Drought Severity (DS) across the 93 South African Weather Service’s delineated rainfall districts over South Africa from 1980 to 2019. In the study, the Pearson correlation coefficient dissimilarity and periodogram dissimilarity estimates were used. The results indicate a positive correlation for the Pearson correlation coefficient dissimilarity and a positive value for periodogram of dissimilarity in both the DD and DS. With the Pearson correlation coefficient dissimilarity, the study demonstrates that the values of the SPI-1/EDI pair and the SPI-3/EDI pair exhibit the highest similar values for DD, while the SPI-6/EDI pair shows the highest similar values for DS. Moreover, dissimilarities are more obvious in SPI-12/EDI pair for DD and DS. When a periodogram of dissimilarity is used, the values of the SPI-1/EDI pair and SPI-6/EDI pair exhibit the highest similar values for DD, while SPI-1/EDI displayed the highest similar values for DS. Overall, the two measures show that the highest similarity is obtained in the SPI-1/EDI pair for DS. The results obtainable in this study contribute towards an in-depth knowledge of deviation between the EDI and SPI values for South Africa, depicting that these two drought indices values are replaceable in some rainfall districts of South Africa for drought monitoring and prediction, and this is a step towards the selection of the appropriate drought indices.


2016 ◽  
Vol 44 (2) ◽  
Author(s):  
Amir Weissman ◽  
Emad Matanes ◽  
Arie Drugan

AbstractSonographic estimation of fetal weight is a fundamental part of the routine obstetrical practice and may affect management decisions particularly in multiple gestations. The data available on the accuracy of sonographic estimation of fetal weight in triplets are very limited. In the present study we investigated the accuracy of sonographic fetal weight estimation and discordancy in triplet gestations.We analyzed the sonographic data of 33 sets of triplets born at one medical center between January 2001 and March 2013. Estimated fetal weight was calculated from biometric measurements and compared with actual neonatal weights following delivery. The Pearson correlation coefficient, linear regression analyses, and Bland-Altman method were used for statistical comparisons.The differences between predicted and actual birth weights (ABW) were <10% in 69 newborns (70%), 10%–20% in 19 newborns (19%), and more than 20% in 11 newborns (11%). There was a good correlation between predicted and ABW (correlation coefficient=0.928,Weight assessment in triplets does not fall behind that of singletons or twins, and decisions based upon these examinations are reliable in the majority of cases.


PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 708-711
Author(s):  
Matthew W. Gillman ◽  
Bernard Rosner ◽  
Denis A. Evans ◽  
Laurel A. Smith ◽  
James O. Taylor ◽  
...  

Previous studies of childhood blood pressure have shown tracking correlations, which estimate the magnitude of association between initial and subsequent measurements, to be lower than corresponding adult values. Inasmuch as this disparity could arise from failing to account for a larger week-to-week variability in children, blood pressure was measured for 4 successive years, on four weekly visits in each year, and with three measurements at each visit, using a random-zero sphygmomanometer, in a cohort of 333 schoolchildren aged 8 through 15 at entry. Ninety percent of subjects had measurements in 1 or more years of follow-up. For all follow-up periods (1, 2, and 3 years from baseline), the Pearson correlation coefficient (r) for both systolic and diastolic blood pressure rose substantially with the number of weekly visits used to calculate each subject's yearly blood pressure (P &lt; .0001). For systolic pressure, the 3-year r values for 1, 2, 3, and 4 visits were .45, .55, .64, and .69, respectively. For diastolic pressure (Korotkoff phase 4), the corresponding values were .28, .41, .47, and .54. These higher multiple-visit estimates of tracking approximate published adult values and raise the possibility that prediction of adult blood pressure from childhood measurements may be improved by averaging readings from multiple weekly visits.


2021 ◽  
Vol 58 (8) ◽  
pp. 0810025
Author(s):  
李硕 Li Shuo ◽  
韩迎东 Han Yingdong ◽  
王双 Wang Shuang ◽  
刘琨 Liu Kun ◽  
江俊峰 Jiang Junfeng ◽  
...  

2016 ◽  
Vol 216 ◽  
pp. 208-215 ◽  
Author(s):  
Haomiao Zhou ◽  
Zhihong Deng ◽  
Yuanqing Xia ◽  
Mengyin Fu

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