scholarly journals Concordance between the Clinical Definition of Polypathological Patient versus Automated Detection by Means of Combined Identification through ICD-9-CM Codes

2019 ◽  
Vol 8 (5) ◽  
pp. 613 ◽  
Author(s):  
Juan Gómez-Salgado ◽  
Máximo Bernabeu-Wittel ◽  
Carmen Aguilera-González ◽  
Juan Antonio Goicoechea-Salazar ◽  
Daniel Larrocha ◽  
...  
Keyword(s):  
Medical History ◽  
Intraclass Correlation ◽  
Screening Method ◽  
Automated Detection ◽  
Automatic Identification ◽  
Cross Sectional ◽  
Data Set ◽  
Predictive Values ◽  
Definition Of ◽  
Polypathological Patient

It is unknown whether the digital application of automated ICD-9-CM codes recorded in the medical history are useful for a first screening in the detection of polypathological patients. In this study, the objective was to identify the degree of intra- and inter-observer concordance in the identification of in-patient polypathological patients between the standard clinical identification method and a new automatic method, using the basic minimum data set of ICD-9-CM codes in the digital medical history. For this, a cross-sectional multicenter study with 1518 administratively discharged patients from Andalusian hospitals during the period of 2013–2014 has been carried out. For the concordance between the clinical definition of a polypathological patient and the polypathological patient classification according to ICD-9-CM coding, a 0.661 kappa was obtained (95% confidence interval (CI); 0.622–0.701) with p < 0.0001. The intraclass correlation coefficient between both methods for the number of polypathological patient categories was 0.745 (95% CI; 0.721–0.768; p < 0.0001). The values of sensitivity, specificity, positive-, and negative predictive values of the automated detection using ICD-9-CM coding were 78%, 88%, 78%, and 88%, respectively. As conclusion, the automatic identification of polypathological patients by detecting ICD-9-CM codes is useful as a screening method for in-hospital patients.

scholarly journals HIV Viral Load Estimation Using Hematocrit Corrected Dried Blood Spot Results on a BioMerieux NucliSENS® Platform

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 86 ◽  
Author(s):  
Charles Nyagupe ◽  
Hemant Deepak Shewade ◽  
Serge Ade ◽  
Collins Timire ◽  
Hannock Tweya ◽  
...  
Keyword(s):  
Viral Load ◽  
Correction Factor ◽  
Intraclass Correlation ◽  
Dried Blood Spot ◽  
Reference Laboratory ◽  
Operating Characteristics ◽  
Hiv Viral Load ◽  
Cross Sectional ◽  
Predictive Values ◽  
Blood Spot

While reporting human immunodeficiency virus (HIV) viral load (VL) using dried blood spot (DBS) in the BioMerieux NucliSENS platform, application of the hematocrit correction factor has been suggested. In this cross-sectional study from the National Microbiology Reference Laboratory of Zimbabwe, we assessed whether hematocrit correction (individual and/or mean) in DBS results improved the correlation with plasma VL and prediction of VL non-suppression (≥1000 copies per ml in plasma). Of 517 specimens during August–December 2018, 65(12.6%) had non-suppressed plasma VL results. The hematocrit correction factor ranged from 1.3 to 2.0 with a mean of 1.6, standard deviation (SD: 1.5, 1.7). The intraclass correlation (ICC) for mean (0.859, 95% CI: 0.834, 0.880) and individual (0.809, 95% CI: 0.777, 0.837) hematocrit corrected DBS results were not significantly different. The uncorrected DBS results had a significantly lower ICC (0.640, 95% CI: 0.586, 0.688) when compared to corrected DBS results. There were no significant differences in validity, predictive values, and areas under the receiver operating characteristics curves for all three DBS results when predicting VL non-suppression. To conclude, hematocrit correction of DBS VL results improved agreement with the plasma results but did not improve prediction of VL non-suppression. The results were not significantly different for individual and mean corrected results.

scholarly journals Validity and reliability of the EULAR instrument RAID.7 as a tool to assess individual domains of impact of disease in rheumatoid arthritis: a cross-sectional study of 671 patients

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001539
Author(s):  
Catia Duarte ◽  
Eduardo José Ferreira Santos ◽  
Ricardo J O Ferreira ◽  
Tore K Kvien ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sleep Disturbance ◽  
Rating Scale ◽  
Intraclass Correlation ◽  
Well Being ◽  
Validity And Reliability ◽  
Open Label ◽  
Cross Sectional ◽  
Data Set ◽  
Disease Impact

ObjectiveThe rheumatoid arthritis impact of disease (RAID) questionnaire comprises seven patient-important domains of disease impact (pain, function, fatigue, sleep disturbance, emotional well-being, physical well-being, coping). RAID was validated as a pooled-weighted score. Its seven individual items separately could provide a valuable tool in clinical practice to guide interventions targeting the patient’s experience of the disease. The aim was to separately assess the psychometric properties of each of the seven numeric rating scale (NRS) of the RAID (RAID.7).Material and methodsPost hoc analyses of data from the cross-sectional RAID study and from the Rainbow study, an open-label 12-week trial of etanercept in patients with RA. Construct validity of each NRS was assessed cross-sectionally in the RAID data set by Spearman’s correlation with the respective external instrument of reference. Using the rainbow data set, we assessed reliability through intraclass correlation coefficient between the screening and the baseline visits and responsiveness (sensitivity to change) by standardised response mean between baseline and 12 weeks.ResultsA total of 671 patients with RA with features of established disease were analysed, 563 and 108 from RAID and Rainbow, respectively. The NRS correlated moderately to strongly with the respective external instrument of reference (r=0.62–0.81). Reliability ranged from 0.64 (0.51–0.74) (pain) to 0.83 (0.76–0.88) (sleep disturbance) and responsiveness from 0.93 (0.73–1.13) (sleep disturbance) to 1.34 (1.01–1.64) (pain).ConclusionThe separate use of the individual NRS of RAID (RAID.7) is valid, feasible, reliable and sensitive to change, representing an opportunity to improve the assessment and treatment of disease impact with minimal questionnaire burden.Trial registration numberNCT00768053.

Do Questions About Lead Exposure Predict Elevated Lead Levels?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 192-194 ◽  
Author(s):  
David M. Tejeda ◽  
Deborah D. Wyatt ◽  
Barry R. Rostek ◽  
William B. Solomon
Keyword(s):  
High Risk ◽  
Disease Control ◽  
Lead Poisoning ◽  
Screening Method ◽  
Predictive Values ◽  
Pediatric Clinic ◽  
Control And Prevention ◽  
Lead Levels ◽  
Centers For Disease Control ◽  
Definition Of

Objective. To assess the usefulness of the lead poisoning questionnaire developed by the Centers for Disease Control and Prevention as a screening tool for elevated lead levels. Methods. This descriptive study used a five-question questionnaire at our hospital-based general pediatric clinic and in two local private practices. We obtained venous lead levels from 485 children aged 9 months to 6 years who were brought for health supervision visits. The questionnaire was completed by a primary caretaker of 330 patients (68%). Contingency tables were used to compare lead levels with the responses on the questionnaire. Results. Lead levels of ≥10 µg/dL were found in 23 (7%) of 330 who completed the questionnaire. Caretakers of children with elevated lead levels were more likely to answer yes to questions about chipping paint and home remodeling than those whose children had levels &lt;10 (P = .0001). These questions had sensitivities for detecting elevated lead levels of 70% and 74% with negative predictive values of 97% and 98%, respectively. Questions about known contacts with lead poisoning and job or industrial exposure to lead each had sensitivities of &lt;10%. The Centers for Disease Control and Prevention's definition of high risk for lead poisoning (one or more positive responses) was nearly 90% sensitive for detecting elevated lead levels with a negative predictive value of 99%. Conclusion. This risk assessment questionnaire is an effective screening method for elevated lead levels in our population. Questions about the home environment were more sensitive indicators of elevated lead levels than other standard high-risk questions.

scholarly journals Reliability of Capillary Complete Blood Count in Children With Acute Gastroenteritis

2021 ◽  
Vol 9 ◽  
Author(s):  
Hanna Wielińska-Wiśniewska ◽  
Jan K. Nowak ◽  
Michał Da̧browski ◽  
Paula Szydłowska ◽  
Mariusz Szczepanik ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Blood Count ◽  
Complete Blood Count ◽  
Characteristic Curve ◽  
Venous Blood ◽  
Intraclass Correlation ◽  
Capillary Blood ◽  
Cross Sectional ◽  
Predictive Values ◽  
The Mean

Background: To assess the reliability of complete blood count (CBC) in the capillary blood of children with acute gastroenteritis (AGE), with a focus on leukocytes.Methods: This was a retrospective cross-sectional study. Complete blood count was compared between the capillary and venous blood in children admitted to a pediatric gastroenterology department with primary diagnosis of AGE (ICD-10 A09, A08.0, A08.2). Capillary blood was obtained in the emergency room and venous blood was sampled in the ward shortly thereafter during peripheral intravenous line placement.Results: One hundred and forty children were included. The mean (±SD) age and weight of patients were 3.0 ± 2.9 years and 16 ± 9 kg; 26% had leukocytosis. The mean difference between obtaining results of capillary and venous blood tests was 2 ± 1 h. Area under the receiver operating characteristic curve (AUC) for the identification of leukocytosis using the capillary blood was 0.98 (95% CI 0.96–1.0). The sensitivity and specificity were 86 and 98%, respectively (accuracy 95%). The positive and negative predictive values were 94 and 95%, respectively. The intraclass correlation coefficient revealed high concordance between capillary and venous CBC measurements (leukocyte count 0.94, hemoglobin 0.88, erythrocyte count 0.77, hematocrit 0.79, platelet count 0.90). Matched pairs comparisons revealed marginally higher erythrocytes (difference of medians: 0.2 T/L), hemoglobin (0.3 g/dL), hematocrit (1.0%), and platelets (9 G/L) in the capillary blood.Conclusion: Capillary CBC is useful in detecting leukocytosis in children with AGE.

Suicide Ideation and Attempt in a Community Cohort of Urban Aboriginal Youth: A Cross-Sectional Study

Crisis ◽  
2013 ◽  
Vol 34 (4) ◽  
pp. 251-261 ◽  
Author(s):  
Joanne N. Luke ◽  
Ian P. Anderson ◽  
Graham J. Gee ◽  
Reg Thorpe ◽  
Kevin G. Rowley ◽  
...  
Keyword(s):  
Health Service ◽  
Indigenous People ◽  
Suicide Ideation ◽  
Aboriginal Health ◽  
Cross Sectional ◽  
Data Set ◽  
Indigenous Youth ◽  
Aboriginal Youth ◽  
Social Distress ◽  
Suicide Behavior

Background: There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. Aims: To examine the prevalence of suicide ideation and attempt and the associated factors for a community 1 The term ”community” refers specifically to Koori people affiliated with the Victorian Aboriginal Health Service. cohort of Koori 2 The term ”Koori” refers to indigenous people from the south-eastern region of Australia, including Melbourne. The term ”Aboriginal” has been used when referring to indigenous people from Australia. The term ”indigenous” has been used throughout this article when referring to the first people of a nation within an international context. (Aboriginal) youth. Method: Data were obtained from the Victorian Aboriginal Health Service (VAHS) Young People’s Project (YPP), a community initiated cross-sectional data set. In 1997/1998, self-reported data were collected for 172 Koori youth aged 12–26 years living in Melbourne, Australia. The data were analyzed to assess the prevalence of current suicide ideation and lifetime suicide attempt. Principal components analysis (PCA) was used to identify closely associated social, emotional, behavioral, and cultural variables at baseline and Cox regression modeling was then used to identify associations between PCA components and suicide ideation and attempt. Results: Ideation and attempt were reported at 23.3% and 24.4%, respectively. PCA yielded five components: (1) emotional distress, (2) social distress A, (3) social distress B, (4) cultural connection, (5) behavioral. All were positively and independently associated with suicide ideation and attempt, while cultural connection showed a negative association. Conclusions: Suicide ideation and attempt were common in this cross-section of indigenous youth with an unfavorable profile for the emotional, social, cultural, and behavioral factors.

Financial distress determinants among SMEs: empirical evidence from Sweden

2020 ◽  
Vol 47 (3) ◽  
pp. 547-560 ◽  
Author(s):  
Darush Yazdanfar ◽  
Peter Öhman
Keyword(s):  
Financial Crisis ◽  
Financial Distress ◽  
Large Scale ◽  
Global Financial Crisis ◽  
Binary Logistic Regression ◽  
Data Availability ◽  
Cross Sectional ◽  
Data Set ◽  
Content Type ◽  
The Global Financial Crisis

PurposeThe purpose of this study is to empirically investigate determinants of financial distress among small and medium-sized enterprises (SMEs) during the global financial crisis and post-crisis periods.Design/methodology/approachSeveral statistical methods, including multiple binary logistic regression, were used to analyse a longitudinal cross-sectional panel data set of 3,865 Swedish SMEs operating in five industries over the 2008–2015 period.FindingsThe results suggest that financial distress is influenced by macroeconomic conditions (i.e. the global financial crisis) and, in particular, by various firm-specific characteristics (i.e. performance, financial leverage and financial distress in previous year). However, firm size and industry affiliation have no significant relationship with financial distress.Research limitationsDue to data availability, this study is limited to a sample of Swedish SMEs in five industries covering eight years. Further research could examine the generalizability of these findings by investigating other firms operating in other industries and other countries.Originality/valueThis study is the first to examine determinants of financial distress among SMEs operating in Sweden using data from a large-scale longitudinal cross-sectional database.

scholarly journals Incidence Correction Factors for Moderate and Severe Acute Child Malnutrition From 2 Longitudinal Cohorts in Mali and Burkina Faso

2020 ◽  
Vol 189 (12) ◽  
pp. 1623-1627
Author(s):  
Francisco M Barba ◽  
Lieven Huybregts ◽  
Jef L Leroy
Keyword(s):  
Burkina Faso ◽  
Low Income ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Incidence Data ◽  
Moderate Acute Malnutrition ◽  
Cluster Randomized ◽  
Definition Of ◽  
Mid Upper Arm Circumference

Abstract Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies, which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor $K$, obtained from the few available cohorts that measured AM. We estimated $K$ factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from 2 cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using complete (weight-for-length z score, mid-upper arm circumference (MUAC), and edema) and partial (MUAC, edema) definitions of SAM and MAM. $K$ estimates for SAM were 9.4 and 5.7 in Burkina Faso and in Mali, respectively; K estimates for MAM were 4.7 in Burkina Faso and 5.1 in Mali. The MUAC and edema–based definition of AM did not lead to different $K$ estimates. Our results suggest that $K$ can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.

scholarly journals The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

2021 ◽  
Author(s):  
Alex Bató ◽  
Valentin Brodszky ◽  
L. Hunor Gergely ◽  
Krisztián Gáspár ◽  
Norbert Wikonkál ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Hidradenitis Suppurativa ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Life Quality ◽  
Measurement Properties ◽  
Economic Evaluations ◽  
Health State ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

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