scholarly journals Predicting Biologic Therapy Outcome of Patients With Spondyloarthritis: Joint Models for Longitudinal and Survival Analysis

10.2196/26823 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e26823
Author(s):  
Carolina Barata ◽  
Ana Maria Rodrigues ◽  
Helena Canhão ◽  
Susana Vinga ◽  
Alexandra M Carvalho
Keyword(s):  
Survival Analysis ◽  
Electronic Medical Records ◽  
Rheumatic Diseases ◽  
Medical Records ◽  
Biologic Therapy ◽  
Disease Onset ◽  
Time Interval ◽  
Hla B27 ◽  
Joint Models ◽  
Therapy Failure

Background Rheumatic diseases are one of the most common chronic diseases worldwide. Among them, spondyloarthritis (SpA) is a group of highly debilitating diseases, with an early onset age, which significantly impacts patients’ quality of life, health care systems, and society in general. Recent treatment options consist of using biologic therapies, and establishing the most beneficial option according to the patients’ characteristics is a challenge that needs to be overcome. Meanwhile, the emerging availability of electronic medical records has made necessary the development of methods that can extract insightful information while handling all the challenges of dealing with complex, real-world data. Objective The aim of this study was to achieve a better understanding of SpA patients’ therapy responses and identify the predictors that affect them, thereby enabling the prognosis of therapy success or failure. Methods A data mining approach based on joint models for the survival analysis of the biologic therapy failure is proposed, which considers the information of both baseline and time-varying variables extracted from the electronic medical records of SpA patients from the database, Reuma.pt. Results Our results show that being a male, starting biologic therapy at an older age, having a larger time interval between disease start and initiation of the first biologic drug, and being human leukocyte antigen (HLA)–B27 positive are indicators of a good prognosis for the biological drug survival; meanwhile, having disease onset or biologic therapy initiation occur in more recent years, a larger number of education years, and higher values of C-reactive protein or Bath Ankylosing Spondylitis Functional Index (BASFI) at baseline are all predictors of a greater risk of failure of the first biologic therapy. Conclusions Among this Portuguese subpopulation of SpA patients, those who were male, HLA-B27 positive, and with a later biologic therapy starting date or a larger time interval between disease start and initiation of the first biologic therapy showed longer therapy adherence. Joint models proved to be a valuable tool for the analysis of electronic medical records in the field of rheumatic diseases and may allow for the identification of potential predictors of biologic therapy failure.

scholarly journals Predicting Biologic Therapy Outcome of Patients With Spondyloarthritis: Joint Models for Longitudinal and Survival Analysis (Preprint)

2020 ◽  
Author(s):  
Carolina Barata ◽  
Ana Maria Rodrigues ◽  
Helena Canhão ◽  
Susana Vinga ◽  
Alexandra M Carvalho
Keyword(s):  
Survival Analysis ◽  
Electronic Medical Records ◽  
Rheumatic Diseases ◽  
Medical Records ◽  
Biologic Therapy ◽  
Disease Onset ◽  
Time Interval ◽  
Hla B27 ◽  
Joint Models ◽  
Therapy Failure

BACKGROUND Rheumatic diseases are one of the most common chronic diseases worldwide. Among them, spondyloarthritis (SpA) is a group of highly debilitating diseases, with an early onset age, which significantly impacts patients’ quality of life, health care systems, and society in general. Recent treatment options consist of using biologic therapies, and establishing the most beneficial option according to the patients’ characteristics is a challenge that needs to be overcome. Meanwhile, the emerging availability of electronic medical records has made necessary the development of methods that can extract insightful information while handling all the challenges of dealing with complex, real-world data. OBJECTIVE The aim of this study was to achieve a better understanding of SpA patients’ therapy responses and identify the predictors that affect them, thereby enabling the prognosis of therapy success or failure. METHODS A data mining approach based on joint models for the survival analysis of the biologic therapy failure is proposed, which considers the information of both baseline and time-varying variables extracted from the electronic medical records of SpA patients from the database, Reuma.pt. RESULTS Our results show that being a male, starting biologic therapy at an older age, having a larger time interval between disease start and initiation of the first biologic drug, and being human leukocyte antigen (HLA)–B27 positive are indicators of a good prognosis for the biological drug survival; meanwhile, having disease onset or biologic therapy initiation occur in more recent years, a larger number of education years, and higher values of C-reactive protein or Bath Ankylosing Spondylitis Functional Index (BASFI) at baseline are all predictors of a greater risk of failure of the first biologic therapy. CONCLUSIONS Among this Portuguese subpopulation of SpA patients, those who were male, HLA-B27 positive, and with a later biologic therapy starting date or a larger time interval between disease start and initiation of the first biologic therapy showed longer therapy adherence. Joint models proved to be a valuable tool for the analysis of electronic medical records in the field of rheumatic diseases and may allow for the identification of potential predictors of biologic therapy failure.

Lack of association of biologic therapy for psoriasis with psychiatric illness: An electronic medical records cohort study

2019 ◽  
Vol 81 (3) ◽  
pp. 709-716 ◽  
Author(s):  
David J. Margolis ◽  
Daniel Shin ◽  
Megan H. Noe ◽  
Marilyn T. Wan ◽  
Ketaki Bhate ◽  
...  
Keyword(s):  
Cohort Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Psychiatric Illness ◽  
Biologic Therapy

scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Frequent Mobile Electronic Medical Records (EMR) Users Respond More Quickly to Emergency Department Consultation Requests (Preprint)

2019 ◽  
Author(s):  
Kwang Yul Jung ◽  
Su Jin Kim ◽  
Ki Hyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Significant Inverse Relationship ◽  
Clinical Scenarios ◽  
The Relationship

BACKGROUND Specialty consultation is a critical aspect of an emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen the ED overcrowding. Although mobile electronic medical records (mEMR) are being increasingly utilized and are known to improve the workflow of healthcare providers, limited studies have evaluated its effectiveness in real-life clinical scenarios. OBJECTIVE We aimed to determine the association between response duration to ED specialty consultation request and frequency of mEMR use. METHODS This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mEMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from the PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mEMR. We merged both data using doctors’ de-identification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mEMR usage and time interval from ED request to the completion of the consultation by specialty doctors. Secondary outcome was the relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests. RESULTS A total of 25,454 consultations requests were made for 15,555 patients, and 271 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mEMR, 212 doctors used mEMR in specialty consultation process. According to the mEMR usage pattern, the average usage frequency of all users was 13.3/day, and the average duration of the completion of the specialty consultation was 51.0 min. For 21,885 completed consultations, there was a significant inverse relationship between the frequency of mEMR usage and time interval from ED request to consultation completion by specialty doctors. (Coefficient: -0.19 (-0.32 to -0.06), P<.01) Of 23,692 consultations had response time stamp among inclusions. There was also a significant inverse relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests (coefficient: -0.17 (-0.30 to -0.04), P=.01). CONCLUSIONS Our findings suggest that frequent mEMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data

CMAJ Open ◽  
2016 ◽  
Vol 4 (2) ◽  
pp. E205-E212 ◽  
Author(s):  
J. Widdifield ◽  
S. Bernatsky ◽  
J. C. Thorne ◽  
C. Bombardier ◽  
R. L. Jaakkimainen ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Medical Records ◽  
Administrative Data ◽  
Rheumatic Diseases ◽  
Medical Records ◽  
Data Linkage ◽  
Linkage Study ◽  
Wait Times

Allergic Comorbidity of Asthma or Wheezing, Allergic Rhinitis, and Eczema: Result From 333 029 Allergic Children in Shanghai, China

2019 ◽  
Vol 34 (2) ◽  
pp. 189-195
Author(s):  
Heyu Ji ◽  
Yi Hu ◽  
Ting Zhang ◽  
Yizhong Wang ◽  
Li Shen ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Immunoglobulin E ◽  
Disease Onset ◽  
Allergic Diseases ◽  
Health Concern ◽  
Onset Age ◽  
Public Health Concern ◽  
Total Immunoglobulin

Background Allergic diseases have become a worldwide public health concern. A defining feature of allergic diseases is they often coexist in children from birth to adolescence. Objective To investigate the prevalence of comorbid allergic diseases in allergic children in Shanghai, China. Methods A retrospective study of 333 029 children diagnosed with allergic diseases aged 0 to 12 years (mean age: 3.04 years, 59.3% boys) was conducted using the electronic medical records of Shanghai Children’s Hospital from January 2013 to July 2018. Comorbidity of allergic diseases is defined as the coexistence of 2 or 3 following diseases in the same child such as asthma (AS)/wheezing, allergic rhinitis (AR), or eczema (EC). Results The proportion of children with comorbid allergic diseases was 6.7% (22 351/333 029). Among them, EC + AS/wheezing was the most common (61.3%, 13 711/22 351). Children with a comorbidity had significantly earlier disease onset age than subjects with only 1 disease (2.72 vs 3.06, P < .05). The serum total immunoglobulin E (tIgE) levels of children with comorbid allergic diseases were higher than those with only 1 disease. In children with a disease onset age of 0 to 9 years, the levels of tIgE for children with AS/wheezing + EC were higher than children with AS/wheezing only or EC only; in children with disease onset age of 2 to 5 and 10 to 12 years, the levels of tIgE for children with AS/wheezing + AR were higher than children with AS/wheezing only or AR only; in children with a disease onset age of 2 to 5 years, the levels of tIgE for children with AR + EC were higher than children with AR only or EC only. Conclusion Comorbidity of allergic diseases is common in children in Shanghai, China. The onset age of comorbidity is earlier than that of only 1 disease, and the levels of serum tIgE are higher in patients with an allergic comorbidity.

scholarly journals Clinical Features of Imported Chinese COVID-19 Patients Following Chinese Inactivated Vaccines Injection Abroad

2021 ◽  
Author(s):  
Jianwu Li ◽  
Na Jiang ◽  
Qing-Lei Zeng ◽  
Yue Zhang ◽  
Yao Chu ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Clinical Features ◽  
Medical Records ◽  
Severe Case ◽  
Shaanxi Province ◽  
Time Interval ◽  
Common Symptom ◽  
Limited Data ◽  
Inactivated Vaccines ◽  
The Mean

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has been demonstrated as an effective way to reduce the risk of coronavirus disease 2019 (COVID-19), and only a few vaccinees suffered from SARS-CoV-2 infection. However, limited data concerning the clinical features of these vaccinees infected with SARS-CoV-2 can be identified. Methods We retrospectively collected and analyzed epidemiological and clinical characteristics data of the imported COVID-19 cases who received Chinese inactivated vaccines abroad. Data were extracted from electronic medical records from a designated hospital in the Shaanxi Province of China between March 22 and May 17, 2021. Results Totally, 46 confirmed SARS-CoV-2 infection patients were enrolled. The mean age was 40.5 years (range 20-61), 41 (89.1%) are male. Eighteen (39.1%) patients were from Pakistan. Fourteen (30.4%) patients had at least one comorbidity. Forty (87.0%) and 6 cases were fully vaccinated and partly vaccinated. The time interval between vaccination and infection was 88 days (IQR, 33-123), 31 (67.4%) and 15 (32.6%) were asymptomatic and symptomatic cases, respectively. Fever (3/46, 6.5%) was the most common symptom; however, none had a body temperature higher than 38.0℃, and no severe case was observed. Notably, the rate of SARS-CoV-2 shedding discontinuation at 7 days after hospitalization in asymptomatic cases was higher than symptomatic one (93.5% vs 40%, P < 0.0001). Conclusions Individuals who received Chinese inactivated vaccines abroad remain have the probability to be infected with SARS-CoV-2, but all the vaccinees infected with SARS-CoV-2 were asymptomatic or had mild symptoms with favorable clinical outcomes.

Adolescent Substance Use Screening Integrated With Electronic Medical Records

2014 ◽  
Author(s):  
C. McKenna ◽  
B. Gaines ◽  
C. Hatfield ◽  
S. Helman ◽  
L. Meyer ◽  
...  
Keyword(s):  
Substance Use ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Adolescent Substance Use ◽  
Adolescent Substance
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