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Article ; Online: Practitioner's Guide to Latent Class Analysis: Methodological Considerations and Common Pitfalls.

Sinha, Pratik / Calfee, Carolyn S / Delucchi, Kevin L

2020 Volume 49, Issue 1, Page(s) e63–e79

Abstract: Latent class analysis is a probabilistic modeling algorithm that allows clustering of data and statistical inference. There has been a recent upsurge in the application of latent class analysis in the fields of critical care, respiratory medicine, and ... ...

Abstract	Latent class analysis is a probabilistic modeling algorithm that allows clustering of data and statistical inference. There has been a recent upsurge in the application of latent class analysis in the fields of critical care, respiratory medicine, and beyond. In this review, we present a brief overview of the principles behind latent class analysis. Furthermore, in a stepwise manner, we outline the key processes necessary to perform latent class analysis including some of the challenges and pitfalls faced at each of these steps. The review provides a one-stop shop for investigators seeking to apply latent class analysis to their data.
MeSH term(s)	Data Interpretation, Statistical ; Humans ; Latent Class Analysis ; Statistics as Topic
Language	English
Publishing date	2020-11-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000004710
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Article ; Online: The attributable mortality of acute respiratory distress syndrome.

Auriemma, Catherine L / Delucchi, Kevin / Liu, Kathleen D / Calfee, Carolyn S

Intensive care medicine

2020 Volume 46, Issue 7, Page(s) 1510–1511

MeSH term(s)	Acute Lung Injury ; Critical Illness ; Humans ; Respiratory Distress Syndrome ; Sepsis
Keywords	covid19
Language	English
Publishing date	2020-05-25
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-020-06099-y
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 1089: Show issues

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Article ; Online: A cluster-randomized trial of a brief multi-component intervention to improve tobacco outcomes in substance use treatment.

Guydish, Joseph / McCuistian, Caravella / Hosakote, Sindhushree / Le, Thao / Masson, Carmen L / Campbell, Barbara K / Delucchi, Kevin

Substance abuse treatment, prevention, and policy

2023 Volume 18, Issue 1, Page(s) 34

Abstract: Background: Smoking prevalence is high among people in substance use disorder (SUD) treatment, and program interventions to address smoking are often complex and lengthy. This cluster-randomized trial tested whether a brief multi-component intervention ... ...

Abstract	Background: Smoking prevalence is high among people in substance use disorder (SUD) treatment, and program interventions to address smoking are often complex and lengthy. This cluster-randomized trial tested whether a brief multi-component intervention impacted tobacco outcomes among staff and clients. Methods: Seven SUD treatment programs were randomly assigned to the multi-component intervention or to waitlist control. The 6-month intervention included a leadership motivation assessment, program incentives, 4 staff training sessions and a leadership learning community session. Survey data were collected from staff and clients at pre- and post-intervention. Outcomes were first compared across condition (intervention vs waitlist control), and then examined pre- to post-intervention with condition collapsed. Results: Staff in the intervention (n = 48) and control conditions (n = 26) did not differ at post-intervention on smoking prevalence, self-efficacy to help clients quit, or practices used to help clients quit smoking. Intervention clients (n = 113) did not differ from controls (n = 61) in smoking prevalence or receipt of tobacco services. Pre-post comparisons collapsed across condition showed a decrease in client and staff smoking prevalence, which could not be attributed to the intervention, and a decrease in client receipt of cessation medication. Conclusion: The brief multi-component intervention did not support changes in smoking prevalence or in tobacco-related services received by clients. Other intervention features are needed to reduce smoking among SUD clients. Trial registration: Randomization occurred at the program level and outcomes measured are program-level measures. Accordingly, the trial is not registered.
MeSH term(s)	Humans ; Smoking Cessation ; Smoking/epidemiology ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/therapy ; Tobacco Smoking/epidemiology
Language	English
Publishing date	2023-06-16
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2222956-5
ISSN	1747-597X ; 1747-597X
ISSN (online)	1747-597X
ISSN	1747-597X
DOI	10.1186/s13011-023-00539-w
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Article ; Online: Novel subtypes of severe COVID-19 respiratory failure based on biological heterogeneity: a secondary analysis of a randomized controlled trial.

Alipanah-Lechner, Narges / Hurst-Hopf, James / Delucchi, Kevin / Swigart, Lamorna / Willmore, Andrew / LaCombe, Benjamin / Dewar, Robin / Lane, H Clifford / Lallemand, Perrine / Liu, Kathleen D / Esserman, Laura / Matthay, Michael A / Calfee, Carolyn S

Critical care (London, England)

2024 Volume 28, Issue 1, Page(s) 56

Abstract: ... requiring ≥ 6 L/min supplemental oxygen. Seventeen hypothesis-directed protein biomarkers were measured ...

Abstract	Background: Despite evidence associating inflammatory biomarkers with worse outcomes in hospitalized adults with COVID-19, trials of immunomodulatory therapies have met with mixed results, likely due in part to biological heterogeneity of participants. Latent class analysis (LCA) of clinical and protein biomarker data has identified two subtypes of non-COVID acute respiratory distress syndrome (ARDS) with different clinical outcomes and treatment responses. We studied biological heterogeneity and clinical outcomes in a multi-institutional platform randomized controlled trial of adults with severe COVID-19 hypoxemic respiratory failure (I-SPY COVID). Methods: Clinical and plasma protein biomarker data were analyzed from 400 trial participants enrolled from September 2020 until October 2021 with severe COVID-19 requiring ≥ 6 L/min supplemental oxygen. Seventeen hypothesis-directed protein biomarkers were measured at enrollment using multiplex Luminex panels or single analyte enzyme linked immunoassay methods (ELISA). Biomarkers and clinical variables were used to test for latent subtypes and longitudinal biomarker changes by subtype were explored. A validated parsimonious model using interleukin-8, bicarbonate, and protein C was used for comparison with non-COVID hyper- and hypo-inflammatory ARDS subtypes. Results: Average participant age was 60 ± 14 years; 67% were male, and 28-day mortality was 25%. At trial enrollment, 85% of participants required high flow oxygen or non-invasive ventilation, and 97% were receiving dexamethasone. Several biomarkers of inflammation (IL-6, IL-8, IL-10, sTNFR-1, TREM-1), epithelial injury (sRAGE), and endothelial injury (Ang-1, thrombomodulin) were associated with 28- and 60-day mortality. Two latent subtypes were identified. Subtype 2 (27% of participants) was characterized by persistent derangements in biomarkers of inflammation, endothelial and epithelial injury, and disordered coagulation and had twice the mortality rate compared with Subtype 1. Only one person was classified as hyper-inflammatory using the previously validated non-COVID ARDS model. Conclusions: We discovered evidence of two novel biological subtypes of severe COVID-19 with significantly different clinical outcomes. These subtypes differed from previously established hyper- and hypo-inflammatory non-COVID subtypes of ARDS. Biological heterogeneity may explain inconsistent findings from trials of hospitalized patients with COVID-19 and guide treatment approaches.
MeSH term(s)	Adult ; Humans ; Male ; Middle Aged ; Aged ; Female ; COVID-19 ; SARS-CoV-2 ; Inflammation ; Respiratory Distress Syndrome/therapy ; Oxygen ; Respiratory Insufficiency/therapy ; Biomarkers
Chemical Substances	Oxygen (S88TT14065) ; Biomarkers
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-024-04819-0
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Article ; Online: Molecular Phenotypes of Acute Respiratory Distress Syndrome in the ROSE Trial Have Differential Outcomes and Gene Expression Patterns That Differ at Baseline and Longitudinally over Time.

Sinha, Pratik / Neyton, Lucile / Sarma, Aartik / Wu, Nelson / Jones, Chayse / Zhuo, Hanjing / Liu, Kathleen D / Sanchez Guerrero, Estella / Ghale, Rajani / Love, Christina / Mick, Eran / Delucchi, Kevin L / Langelier, Charles R / Thompson, B Taylor / Matthay, Michael A / Calfee, Carolyn S

American journal of respiratory and critical care medicine

2024 Volume 209, Issue 7, Page(s) 816–828

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Humans ; Phenotype ; Biomarkers ; Respiratory Distress Syndrome ; Blood Proteins/genetics ; Gene Expression
Chemical Substances	Biomarkers ; Blood Proteins
Language	English
Publishing date	2024-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202308-1490OC
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Article ; Online: Subphenotypes Assigned to Pediatric Acute Respiratory Failure Patients Show Differing Outcomes.

Flori, Heidi R / Zhang, Min / Xie, Jiaheng / Yang, Guangyu / Sapru, Anil / Calfee, Carolyn S / Delucchi, Kevin L / Sinha, Pratik / Curley, Martha A Q / Dahmer, Mary K

American journal of respiratory and critical care medicine

2023 Volume 208, Issue 3, Page(s) 331–333

MeSH term(s)	Humans ; Child ; Biomarkers ; Phenotype ; Respiratory Distress Syndrome/therapy ; Respiratory Insufficiency/therapy
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-06-09
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202301-0070LE
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Article ; Online: Measures of both perceived general and specific risks and benefits differentially predict adolescent and young adult tobacco and marijuana use: findings from a Prospective Cohort Study.

McKelvey, Karma / Gaiha, Shivani Mathur / Delucchi, Kevin L / Halpern-Felsher, Bonnie

Humanities & social sciences communications

2021 Volume 8, Issue 1

Abstract: Health behavior theorists and prevention researchers use a variety of measures of adolescent and young adult (AYA) risk and benefit perceptions to predict tobacco-use and marijuana-use behaviors. However, studies have not examined whether and how ... ...

Abstract	Health behavior theorists and prevention researchers use a variety of measures of adolescent and young adult (AYA) risk and benefit perceptions to predict tobacco-use and marijuana-use behaviors. However, studies have not examined whether and how perception measures that ask about likelihood of more general outcomes such as "harm" versus ask about specific risk or benefit outcomes compare or whether they differentially predict AYA willingness to use if one of your best friends were to offer it and intentions to use in the next year; and if these measures have differential ability to predict actual use of tobacco and marijuana. We used data from a prospective cohort of California AYAs to create and test new scales to measure perceptions of specific health and social outcomes related to risks (e.g., smell bad) and benefits (e.g., look cool) related to tobacco and marijuana, and then addressed three questions: (1) Whether and how measures of perceptions of specific social and health risks and benefits (for our purposes "specific measures") and measures of perceived general harm are differentially associated with measures of willingness, social norms, and intentions to use? (2) Are specific versus general measures differentially associated with and predictive of tobacco and cannabis use behavior? (3) Are specific perceptions measures differentially predictive of behavior compared to measures of willingness, social norms, and behavioral intentions? Our results demonstrate that to better predict AYA tobacco and marijuana use, measures that address general outcomes, such as harmfulness, as well as willingness and behavioral intention should be used. We also found that measures of specific perceived risks (short-term, long-term, social) and benefits were unrelated and correlated differently with different products. For example, adolescents perceived both risks and benefits from using products like e-cigarettes, and perceived greater risk from smokeless tobacco compared to combustible cigarettes. These findings indicate that measures of specific perceived social and health outcomes can be useful to discern nuanced differences in motivation for using different substances. Study implications are important for survey dimension-reduction and assessing relationships among perceptions, motivations, and use of tobacco and marijuana products.
Language	English
Publishing date	2021-03-29
Publishing country	England
Document type	Journal Article
ISSN	2662-9992
ISSN (online)	2662-9992
DOI	10.1057/s41599-021-00765-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Menthol cigarette use in substance use disorder treatment before and after implementation of a county-wide flavoured tobacco ban.

Guydish, Joseph R / Straus, Elana R / Le, Thao / Gubner, Noah / Delucchi, Kevin L

Tobacco control

2020 Volume 30, Issue 6, Page(s) 616–622

Abstract: Introduction: This study examined the impact of a San Francisco City and County ban on all flavoured tobacco products, including menthol cigarettes, among clients in residential substance use disorder (SUD) treatment.: Methods: We conducted cross- ... ...

Abstract	Introduction: This study examined the impact of a San Francisco City and County ban on all flavoured tobacco products, including menthol cigarettes, among clients in residential substance use disorder (SUD) treatment. Methods: We conducted cross-sectional surveys of clients at two residential SUD programmes before the County began enforcing the ban (n=160) and twice after enforcement began (n=102, n=120). The samples were compared on demographic characteristics, smoking status, smoking behaviours and the proportion reporting menthol as their usual cigarette. Menthol smokers were asked whether they smoked only menthol cigarettes, mostly menthol, both menthol and non-menthol or mostly non-menthol. Post-ban samples were asked about awareness of the ban and access to menthol cigarettes. Results: In multivariate analyses, we found no evidence that the ban was associated with decreased number of cigarettes per day or increased readiness to quit among current smokers. However, odds were lower post-ban for reporting menthol as the usual cigarette (OR=0.80, 95% CI 0.72 to 0.90), and for smoking only menthol cigarettes (OR=0.19, 95% CI 0.18 to 0.19). Perhaps most importantly, and with the ability to influence all other findings, 50% of self-identified menthol smokers reported purchasing menthol cigarettes in San Francisco nearly 1 year after the ban was implemented. Conclusion: In subgroups where smoking has remained elevated, like those receiving SUD treatment, local menthol bans may have only modest impacts on smoking behaviour. Broader regional, state or national bans, that effectively restrict access to menthol products, may be needed to show stronger effects on smoking behaviour.
MeSH term(s)	Cross-Sectional Studies ; Humans ; Menthol ; Substance-Related Disorders ; Nicotiana ; Tobacco Products
Chemical Substances	Menthol (1490-04-6)
Language	English
Publishing date	2020-11-11
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1146554-2
ISSN	1468-3318 ; 0964-4563
ISSN (online)	1468-3318
ISSN	0964-4563
DOI	10.1136/tobaccocontrol-2020-056000
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Zs.A 3651: Show issues

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Article ; Online: Measures of both perceived general and specific risks and benefits differentially predict adolescent and young adult tobacco and marijuana use

Karma McKelvey / Shivani Mathur Gaiha / Kevin L. Delucchi / Bonnie Halpern-Felsher

Humanities & Social Sciences Communications, Vol 8, Iss 1, Pp 1-

findings from a Prospective Cohort Study

2021 Volume 9

Abstract: Abstract Health behavior theorists and prevention researchers use a variety of measures of adolescent and young adult (AYA) risk and benefit perceptions to predict tobacco-use and marijuana-use behaviors. However, studies have not examined whether and ... ...

Abstract	Abstract Health behavior theorists and prevention researchers use a variety of measures of adolescent and young adult (AYA) risk and benefit perceptions to predict tobacco-use and marijuana-use behaviors. However, studies have not examined whether and how perception measures that ask about likelihood of more general outcomes such as “harm” versus ask about specific risk or benefit outcomes compare or whether they differentially predict AYA willingness to use if one of your best friends were to offer it and intentions to use in the next year; and if these measures have differential ability to predict actual use of tobacco and marijuana. We used data from a prospective cohort of California AYAs to create and test new scales to measure perceptions of specific health and social outcomes related to risks (e.g., smell bad) and benefits (e.g., look cool) related to tobacco and marijuana, and then addressed three questions: (1) Whether and how measures of perceptions of specific social and health risks and benefits (for our purposes “specific measures”) and measures of perceived general harm are differentially associated with measures of willingness, social norms, and intentions to use? (2) Are specific versus general measures differentially associated with and predictive of tobacco and cannabis use behavior? (3) Are specific perceptions measures differentially predictive of behavior compared to measures of willingness, social norms, and behavioral intentions? Our results demonstrate that to better predict AYA tobacco and marijuana use, measures that address general outcomes, such as harmfulness, as well as willingness and behavioral intention should be used. We also found that measures of specific perceived risks (short-term, long-term, social) and benefits were unrelated and correlated differently with different products. For example, adolescents perceived both risks and benefits from using products like e-cigarettes, and perceived greater risk from smokeless tobacco compared to combustible cigarettes. These findings indicate that measures of specific perceived social and health outcomes can be useful to discern nuanced differences in motivation for using different substances. Study implications are important for survey dimension-reduction and assessing relationships among perceptions, motivations, and use of tobacco and marijuana products.
Keywords	History of scholarship and learning. The humanities ; AZ20-999 ; Social Sciences ; H
Subject code	300
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Springer Nature
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Outpatient, combined use of opioid and benzodiazepine medications in the United States, 1993-2014.

Hirschtritt, Matthew E / Delucchi, Kevin L / Olfson, Mark

Preventive medicine reports

2017 Volume 9, Page(s) 49–54

Abstract: The combined use of opioid and benzodiazepine medications increases the risk of hazardous effects, such as respiratory depression. Although recent increases in outpatient use of opioid prescriptions have been documented, there are limited data regarding ... ...

Abstract	The combined use of opioid and benzodiazepine medications increases the risk of hazardous effects, such as respiratory depression. Although recent increases in outpatient use of opioid prescriptions have been documented, there are limited data regarding rates and correlates of combined opioid and benzodiazepines among adults in outpatient settings. Our objective was to examine annual trends in outpatient visits including opioids, benzodiazepines, and their combination among adults as well as clinical and demographic correlates. We used data from the 1993-2014 National Ambulatory Medical Care Survey (NAMCS) among non-elderly (i.e., ages 18-64 years) adults to examine the probability of a visit including an opioid, benzodiazepine, or their combination, in addition to clinical and demographic correlates. From 1993 to 2014, benzodiazepines-with-opioids visits increased from 9.8 to 62.5 (OR = 9.23, 95% CI = 5.45-15.65) per 10,000 visits. Highest-represented groups among benzodiazepines-with-opioids visits were older (50-64 years) (49.1%), white (88.8%), commercially insured (58.0%) patients during their first visit (87.6%) to a primary-care physician (41.9%). We identified a significant increase in the outpatient co-prescription of opioids and benzodiazepines, notably among adults aged 50-64 years during primary-care visits. Educational and policy changes to provide alternatives to benzodiazepine-with-opioid co-prescription and limiting opioid prescription to pain specialists may reduce rates of this potentially hazardous combination.
Language	English
Publishing date	2017-12-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2017.12.010
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