absolute difference
Recently Published Documents


TOTAL DOCUMENTS

1229
(FIVE YEARS 656)

H-INDEX

42
(FIVE YEARS 9)

Author(s):  
Hallie C Prescott ◽  
Rajendra P Kadel ◽  
Julie R Eyman ◽  
Ron Freyberg ◽  
Matthew Quarrick ◽  
...  

Abstract Background The US Veterans Affairs (VA) healthcare system began reporting risk-adjusted mortality for intensive care (ICU) admissions in 2005. However, while the VA’s mortality model has been updated and adapted for risk-adjustment of all inpatient hospitalizations, recent model performance has not been published. We sought to assess the current performance of VA’s 4 standardized mortality models: acute care 30-day mortality (acute care SMR-30); ICU 30-day mortality (ICU SMR-30); acute care in-hospital mortality (acute care SMR); and ICU in-hospital mortality (ICU SMR). Methods Retrospective cohort study with split derivation and validation samples. Standardized mortality models were fit using derivation data, with coefficients applied to the validation sample. Nationwide VA hospitalizations that met model inclusion criteria during fiscal years 2017–2018(derivation) and 2019 (validation) were included. Model performance was evaluated using c-statistics to assess discrimination and comparison of observed versus predicted deaths to assess calibration. Results Among 1,143,351 hospitalizations eligible for the acute care SMR-30 during 2017–2019, in-hospital mortality was 1.8%, and 30-day mortality was 4.3%. C-statistics for the SMR models in validation data were 0.870 (acute care SMR-30); 0.864 (ICU SMR-30); 0.914 (acute care SMR); and 0.887 (ICU SMR). There were 16,036 deaths (4.29% mortality) in the SMR-30 validation cohort versus 17,458 predicted deaths (4.67%), reflecting 0.38% over-prediction. Across deciles of predicted risk, the absolute difference in observed versus predicted percent mortality was a mean of 0.38%, with a maximum error of 1.81% seen in the highest-risk decile. Conclusions and Relevance The VA’s SMR models, which incorporate patient physiology on presentation, are highly predictive and demonstrate good calibration both overall and across risk deciles. The current SMR models perform similarly to the initial ICU SMR model, indicating appropriate adaption and re-calibration.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262403
Author(s):  
Yaser Mokhayeri ◽  
Maryam Nazemipour ◽  
Mohammad Ali Mansournia ◽  
Ashley I. Naimi ◽  
Jay S. Kaufman

Background In settings in which there are time-varying confounders affected by previous exposure and a time-varying mediator, natural direct and indirect effects cannot generally be estimated unbiasedly. In the present study, we estimate interventional direct effect and interventional indirect effect of cigarette smoking as a time-varying exposure on coronary heart disease while considering body weight as a time-varying mediator. Methods To address this problem, the parametric mediational g-formula was proposed to estimate interventional direct effect and interventional indirect effect. We used data from the Multi-Ethnic Study of Atherosclerosis to estimate effect of cigarette smoking on coronary heart disease, considering body weight as time-varying mediator. Results Over a 11-years period, smoking 20 cigarettes per day compared to no smoking directly (not through weight) increased risk of coronary heart disease by an absolute difference of 1.91% (95% CI: 0.49%, 4.14%), and indirectly decreased coronary heart disease risk by -0.02% (95% CI: -0.05%, 0.04%) via change in weight. The total effect was estimated as an absolute 1.89% increase (95% CI: 0.49%, 4.13%). Conclusion The overall absolute impact of smoking to incident coronary heart disease is modest, and we did not discern any important contribution to this effect relayed through changes to bodyweight. In fact, changes in weight because of smoking have no meaningful mediating effect on CHD risk.


2022 ◽  
pp. 153575972110703
Author(s):  
David G. Vossler

Importance: Enzyme-inducing antiseizure medications (eiASMs) have been hypothesized to be associated with long-term risks of cardiovascular disease. Objective: To quantify and model the putative hazard of cardiovascular disease secondary to eiASM use. Design, Setting, and Participants: This cohort study covered January 1990 to March 2019 (median [IQR] follow-up, 9 [4–15], years). The study linked primary care and hospital electronic health records at National Health Service hospitals in England. People aged 18 years or older diagnosed as having epilepsy after January 1, 1990, were included. All eligible patients were included with a waiver of consent. No patients were approached who withdrew consent. Analysis began January 2021 and ended August 2021. Exposures: Receipt of 4 consecutive EI ASMs (carbamazepine, eslicarbazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, rufinamide, or topiramate) following an adult-onset (age >/=18 years) epilepsy diagnosis or repeated exposure in a weighted cumulative exposure model. Main Outcomes and Measures: Three cohorts were isolated, 1 of which comprised all adults meeting a case definition for epilepsy diagnosed after 1990, 1 comprised incident cases diagnosed after 1998 (hospital linkage date), and 1 was limited to adults diagnosed with epilepsy at 65 years or older. Outcome was incident cardiovascular disease (ischemic heart disease or ischemic or hemorrhagic stroke). Hazard of incident cardiovascular disease was evaluated using adjusted propensity-matched survival analyses and weighted cumulative exposure models. Results: Of 10,916,166 adults, 50,888 (.6%) were identified as having period-prevalent cases (median [IQR] age, 32 [19–50] years; 16 584 [53%] female), of whom 31,479 (62%) were diagnosed on or after 1990 and were free of cardiovascular disease at baseline. In a propensity-matched Cox proportional hazards model adjusted for age, sex, baseline socioeconomic status, and cardiovascular risk factors, the hazard ratio for incident cardiovascular disease was 1.21 (95% CI, 1.06–1.39) for those receiving eiASMs. The absolute difference in cumulative hazard diverges by more than 1% and greater after 10 years. For those with persistent exposure beyond 4 prescriptions, the median hazard ratio increased from a median (IQR) of 1.54 (1.28–1.79) when taking a relative defined daily dose of an eiASM of 1 to 2.38 (1.52–3.56) with a relative defined daily dose of 2 throughout a maximum of 25 years' follow-up compared with those not receiving an eiASM. The hazard was elevated but attenuated when restricting analyses to incident cases or those diagnosed when older than 65 years. Conclusions and Relevance: The hazard of incident cardiovascular disease is higher in those receiving eiASMs. The association is dose dependent and the absolute difference in hazard seems to reach clinical significance by approximately 10 years from first exposure.


Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 350
Author(s):  
Emanuele Barabino ◽  
Giovanni Rossi ◽  
Silvia Pamparino ◽  
Martina Fiannacca ◽  
Simone Caprioli ◽  
...  

Delta-radiomics is a branch of radiomics in which features are confronted after time or after introducing an external factor (such as treatment with chemotherapy or radiotherapy) to extrapolate prognostic data or to monitor a certain condition. Immune checkpoint inhibitors (ICIs) are currently revolutionizing the treatment of non-small cell lung cancer (NSCLC); however, there are still many issues in defining the response to therapy. Contrast-enhanced CT scans of 33 NSCLC patients treated with ICIs were analyzed; altogether, 43 lung lesions were considered. The radiomic features of the lung lesions were extracted from CT scans at baseline and at first reassessment, and their variation (delta, Δ) was calculated by means of the absolute difference and relative reduction. This variation was related to the final response of each lesion to evaluate the predictive ability of the variation itself. Twenty-seven delta features have been identified that are able to discriminate radiologic response to ICIs with statistically significant accuracy. Furthermore, the variation of nine features significantly correlates with pseudo-progression.


2022 ◽  
Vol 72 (1) ◽  
pp. 56-66
Author(s):  
S. Karthik Sairam ◽  
P. Muralidhar

High Efficiency Video Coding (HEVC) is a video compression standard that offers 50% more efficiency at the expense of high encoding time contrasted with the H.264 Advanced Video Coding (AVC) standard. The encoding time must be reduced to satisfy the needs of real-time applications. This paper has proposed the Multi- Level Resolution Vertical Subsampling (MLRVS) algorithm to reduce the encoding time. The vertical subsampling minimizes the number of Sum of Absolute Difference (SAD) computations during the motion estimation process. The complexity reduction algorithm is also used for fast coding the coefficients of the quantised block using a flag decision. Two distinct search patterns are suggested: New Cross Diamond Diamond (NCDD) and New Cross Diamond Hexagonal (NCDH) search patterns, which reduce the time needed to locate the motion vectors. In this paper, the MLRVS algorithm with NCDD and MLRVS algorithm with NCDH search patterns are simulated separately and analyzed. The results show that the encoding time of the encoder is decreased by 55% with MLRVS algorithm using NCDD search pattern and 56% with MLRVS using NCDH search pattern compared to HM16.5 with Test Zone (TZ) search algorithm. These results are achieved with a slight increase in bit rate and negligible deterioration in output video quality.


PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003858
Author(s):  
Jane S. Hocking ◽  
Anna Wood ◽  
Meredith Temple-Smith ◽  
Sabine Braat ◽  
Matthew Law ◽  
...  

Background Financial incentives and audit/feedback are widely used in primary care to influence clinician behaviour and increase quality of care. While observational data suggest a decline in quality when these interventions are stopped, their removal has not been evaluated in a randomised controlled trial (RCT), to our knowledge. This trial aimed to determine whether chlamydia testing in general practice is sustained when financial incentives and/or audit/feedback are removed. Methods and findings We undertook a 2 × 2 factorial cluster RCT in 60 general practices in 4 Australian states targeting 49,525 patients aged 16–29 years for annual chlamydia testing. Clinics were recruited between July 2014 and September 2015 and were followed for up to 2 years or until 31 December 2016. Clinics were eligible if they were in the intervention group of a previous cluster RCT where general practitioners (GPs) received financial incentives (AU$5–AU$8) for each chlamydia test and quarterly audit/feedback reports of their chlamydia testing rates. Clinics were randomised into 1 of 4 groups: incentives removed but audit/feedback retained (group A), audit/feedback removed but incentives retained (group B), both removed (group C), or both retained (group D). The primary outcome was the annual chlamydia testing rate among 16- to 29-year-old patients, where the numerator was the number who had at least 1 chlamydia test within 12 months and the denominator was the number who had at least 1 consultation during the same 12 months. We undertook a factorial analysis in which we investigated the effects of removal versus retention of incentives (groups A + C versus groups B + D) and the effects of removal versus retention of audit/feedback (group B + C versus groups A + D) separately. Of 60 clinics, 59 were randomised and 55 (91.7%) provided data (group A: 15 clinics, 11,196 patients; group B: 14, 11,944; group C: 13, 11,566; group D: 13, 14,819). Annual testing decreased from 20.2% to 11.7% (difference −8.8%; 95% CI −10.5% to −7.0%) in clinics with incentives removed and decreased from 20.6% to 14.3% (difference −7.1%; 95% CI −9.6% to −4.7%) where incentives were retained. The adjusted absolute difference in treatment effect was −0.9% (95% CI −3.5% to 1.7%; p = 0.2267). Annual testing decreased from 21.0% to 11.6% (difference −9.5%; 95% CI −11.7% to −7.4%) in clinics where audit/feedback was removed and decreased from 19.9% to 14.5% (difference −6.4%; 95% CI −8.6% to −4.2%) where audit/feedback was retained. The adjusted absolute difference in treatment effect was −2.6% (95% CI −5.4% to −0.1%; p = 0.0336). Study limitations included an unexpected reduction in testing across all groups impacting statistical power, loss of 4 clinics after randomisation, and inclusion of rural clinics only. Conclusions Audit/feedback is more effective than financial incentives of AU$5–AU$8 per chlamydia test at sustaining GP chlamydia testing practices over time in Australian general practice. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12614000595617


2022 ◽  
Vol 8 ◽  
Author(s):  
Na Zhao ◽  
Yang Gao ◽  
Bo Xu ◽  
Weixian Yang ◽  
Lei Song ◽  
...  

Aims: To explore the effect of coronary calcification severity on the measurements and diagnostic performance of computed tomography-derived fractional flow reserve (FFR; CT-FFR).Methods: This study included 305 patients (348 target vessels) with evaluable coronary calcification (CAC) scores from CT-FFR CHINA clinical trial. The enrolled patients all received coronary CT angiography (CCTA), CT-FFR, and invasive FFR examinations within 7 days. On both per-patient and per-vessel levels, the measured values, accuracy, and diagnostic performance of CT-FFR in identifying hemodynamically significant lesions were analyzed in all CAC score groups (CAC = 0, > 0 to <100, ≥ 100 to <400, and ≥ 400), with FFR as reference standard.Results: In total, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under receiver operating characteristics curve (AUC) of CT-FFR were 85.8, 88.7, 86.9, 87.8, 87.1%, 0.90 on a per-patient level and 88.3, 89.3, 89.5, 88.2, 88.9%, 0.88 on a per-vessel level, respectively. Absolute difference of CT-FFR and FFR values tended to elevate with increased CAC scores (CAC = 0: 0.09 ± 0.10; CAC > 0 to <100: 0.06 ± 0.06; CAC ≥ 100 to <400: 0.09 ± 0.10; CAC ≥ 400: 0.11 ± 0.13; p = 0.246). However, no statistically significant difference was found in patient-based and vessel-based diagnostic performance of CT-FFR among all CAC score groups.Conclusion: This prospective multicenter trial supported CT-FFR as a viable tool in assessing coronary calcified lesions. Although large deviation of CT-FFR has a tendency to correlate with severe calcification, coronary calcification has no significant influence on CT-FFR diagnostic performance using the widely-recognized cut-off value of 0.8.


Author(s):  
SUGENG SUGENG

The purpose of the study was to examine the effect of teacher discipline and efficacy on teacher performance moderated by the supervision of the principal at SMA Kabupaten Jepara. The population of high school teachers is approximately 709 more with accidental sampling. The sample is homogeneous as many as 95 teachers. The method used in data collection is using a questionnaire. The data collection technique was through the distribution of questionnaires with a Likert scale of 1 to 5. The method of data analysis was to describe the characteristics of the respondents including gender, age, education, class, and years of service. While the model analysis uses absolute difference moderation, namely the analysis of moderating variables by regressing the absolute difference. In the results 1) Discipline has a positive and significant effect on teacher performance 2) Teacher efficacy has a positive and significant effect on teacher performance, 3) Principal supervision does not moderate the effect of discipline on teacher performance, and 4) Principal supervision does not moderate teacher efficacy on teacher performance. . Thus, similar research is still needed with different populations and samples. ABSTRAKTujuan penelitian adalah untuk menguji pengaruh kedisiplinan dan efikasi guru terhadap kinerja guru dimoderasi supervisi kepala sekolah di SMA Kabupaten Jepara. Populasi guru SMA kira-kira 709 lebih dengan pengambilan sampel accidental sampling. Sampel bersifat homogin sebanyak 95 guru. Metode yang digunakan dalam pengumpulan data adalah menggunakan kuesener. Teknik pengumpulan data melalui penyebaran angket kuesener dengan skala likert 1 sampai 5. Metode analisis data dengan mendeskriptifkan kharakteristik responden meliputi jenis kelamin, usia, pendidikan, golongan, dan masa kerja. Sementara analisis modelnya menggunakan moderasi selisih mutlak yakni analisis variabel moderasi dengan meregresikan selisih mutlak. Pada hasil 1) Kedisiplinan berpengaruh positif dan signifikan terhadap kinerja guru 2) Efikasi guru berpengaruh positif dan signifikan terhadap kinerja guru, 3) Supervisi kepala sekolah tidak memoderasi pengaruh kedisiplinan terhadap kinerja guru ,dan 4) Supervisi kepala sekolah tidak memoderasi efikasi guru terhadap kinerja guru. Dengan demikian masih diperlukan penelitian sejenis dengan populasi dan sampel berbeda.


Author(s):  
Rui Zhou ◽  
Yu-fang Liang ◽  
Hua-Li Cheng ◽  
Wei Wang ◽  
Da-wei Huang ◽  
...  

Abstract Objectives Delta check (DC) is widely used for detecting sample mix-up. Owing to the inadequate error detection and high false-positive rate, the implementation of DC in real-world settings is labor-intensive and rarely capable of absolute detection of sample mix-ups. The aim of the study was to develop a highly accurate DC method based on designed deep learning to detect sample mix-up. Methods A total of 22 routine hematology test items were adopted for the study. The hematology test results, collected from two hospital laboratories, were independently divided into training, validation, and test sets. By selecting six mainstream algorithms, the Deep Belief Network (DBN) was able to learn error-free and artificially (intentionally) mixed sample results. The model’s analytical performance was evaluated using training and test sets. The model’s clinical validity was evaluated by comparing it with three well-recognized statistical methods. Results When the accuracy of our model in the training set reached 0.931 at the 22nd epoch, the corresponding accuracy in the validation set was equal to 0.922. The loss values for the training and validation sets showed a similar (change) trend over time. The accuracy in the test set was 0.931 and the area under the receiver operating characteristic curve was 0.977. DBN demonstrated better performance than the three comparator statistical methods. The accuracy of DBN and revised weighted delta check (RwCDI) was 0.931 and 0.909, respectively. DBN performed significantly better than RCV and EDC. Of all test items, the absolute difference of DC yielded higher accuracy than the relative difference for all methods. Conclusions The findings indicate that input of a group of hematology test items provides more comprehensive information for the accurate detection of sample mix-up by machine learning (ML) when compared with a single test item input method. The DC method based on DBN demonstrated highly effective sample mix-up identification performance in real-world clinical settings.


Coatings ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14
Author(s):  
Guiling Hu ◽  
Wenyang Han ◽  
Jincheng Wei ◽  
Deqing Wang ◽  
Xiaomeng Zhang ◽  
...  

To study the in-situ response and performance of asphalt pavement, instrumenting pavement with a variety of sensors has become one of the most important tools in the field or accelerated load facilities. In the dynamic response collection process, engineers are more concerned with the load position strain of the pavement structure due to wheel wander. This paper proposes a method to obtain the load position and the strain at the load position when there is no lateral-axis positioning system based on multilayer elastic theory. The test section was paved in the field with installed strain sensors to verify and apply the proposed method. The verification results showed that both the calculated load position and load position strain matched the measured values with an absolute difference range of 5–60 mm, 0.5–2.5 με, respectively. The application results showed that the strain at the load position calculated by the proposed method had a good correlation with the temperature, as expected.


Sign in / Sign up

Export Citation Format

Share Document