dfgcompare: a library to support process variant analysis through Markov models

Background Data-driven process analysis is an important area that relies on software support. Process variant analysis is a sort of analysis technique in which analysts compare executed process variants, a.k.a. process cohorts. This comparison can help to identify insights for improving processes. There are a few software supports to enable process cohort comparison based on the frequencies of process activities and performance metrics. These metrics are effective in cohort analysis, but they cannot support cohort comparison based on the probability of transitions among states, which is an important enabler for cohort analysis in healthcare. Results This paper defines an approach to compare process cohorts using Markov models. The approach is formalized, and it is implemented as an open-source python library, named dfgcompare. This library can be used by other researchers to compare process cohorts. The implementation is also used to compare caregivers’ behavior when prescribing drugs in the Stockholm Region. The result shows that the approach enables the comparison of process cohorts in practice. Conclusions We conclude that dfgcompare supports identifying differences among process cohorts.

Does the Implementation of Children's Hospital in the Home affect Health Outcomes for Children with Chronic Respiratory Conditions? A non-contemporary retrospective cohort comparison study

Objective To investigate whether the implementation of a Children’s Hospital in the Home (CHITH) service affects clinical and service outcomes for children with chronic respiratory conditions including cystic fibrosis and non-CF bronchiectasis. Study Design A non-contemporary retrospective cohort comparison study. Setting/Patients Children aged between 1 and 17.99 years who were admitted to Gold Coast University Hospital (GCUH) with a chronic respiratory condition for pulmonary optimisation were eligible. Methods A clinical audit was utilised to compare children with chronic respiratory conditions who were admitted to GCUH in (a) the 12 months prior to implementation of CHITH and (b) the 12-month period following the implementation of CHITH. Outcomes of interest included lung function; inpatient length of stay (days); duration on intravenous antibiotics and weight gain. Normally distributed data was compared using the t-test, while non-parametric data was analysed with the Mann-Whitney test. Results Data was analysed from 58 admissions, 27 (46.55%) of which occurred in the 12 months of traditional management and 31 (53.45%) in the 12 months following the implementation of the CHITH service. A statistically significant reduction in inpatient length of stay was noted following implementation of the CHITH service: 14.25 versus 6.0 days (p-value=0.0001). The pre-CHITH cohort had a non-significant mean improvement of 7.625% in their FEV1 (pred%) compared to 9.75% in the CHITH cohort (p-value=0.44). There was no significant difference in the secondary clinical outcomes. Conclusion The CHITH service provided equitable clinical outcomes for children with a chronic respiratory condition whilst significantly reducing inpatient length of stay.

A Cohort Comparison of Midlife Marital Quality: A Quarter Century of Change

Marital quality has been declining among recent cohorts, but whether this pattern characterizes middle-aged and older married adults is largely unknown. The doubling of the divorce rate among persons over the age of 50 years foretells poorer quality marriages for today’s midlife adults than a generation ago. Combining data on married individuals aged 50–65 years from the 1987-88 National Survey of Families and Households (NSFH) and the 2013 Families and Relationships Study, we conduct a cohort comparison of five dimensions of midlife marital quality. Today’s older adults report more marital disagreement and instability as well as less fairness and interaction with their spouses than their counterparts did a generation ago. The two cohorts report comparable levels of marital happiness. Consistent with the upward trend in divorce during the second half of life, the quality of midlife marriages appears to have declined over the past quarter century.