LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 5 of total 5

Search options

  1. Article ; Online: Clinical and operational insights from data-driven care pathway mapping

    Matthew Manktelow / Aleeha Iftikhar / Magda Bucholc / Michael McCann / Maurice O’Kane

    BMC Medical Informatics and Decision Making, Vol 22, Iss 1, Pp 1-

    a systematic review

    2022  Volume 22

    Abstract: Abstract Background Accumulated electronic data from a wide variety of clinical settings has been processed using a range of informatics methods to determine the sequence of care activities experienced by patients. The “as is” or “de facto” care pathways ...

    Abstract Abstract Background Accumulated electronic data from a wide variety of clinical settings has been processed using a range of informatics methods to determine the sequence of care activities experienced by patients. The “as is” or “de facto” care pathways derived can be analysed together with other data to yield clinical and operational information. It seems likely that the needs of both health systems and patients will lead to increasing application of such analyses. A comprehensive review of the literature is presented, with a focus on the study context, types of analysis undertaken, and the utility of the information gained. Methods A systematic review was conducted of literature abstracting sequential patient care activities (“de facto” care pathways) from care records. Broad coverage was achieved by initial screening of a Scopus search term, followed by screening of citations (forward snowball) and references (backwards snowball). Previous reviews of related topics were also considered. Studies were initially classified according to the perspective captured in the derived pathways. Concept matrices were then derived, classifying studies according to additional data used and subsequent analysis undertaken, with regard for the clinical domain examined and the knowledge gleaned. Results 254 publications were identified. The majority (n = 217) of these studies derived care pathways from data of an administrative/clinical type. 80% (n = 173) applied further analytical techniques, while 60% (n = 131) combined care pathways with enhancing data to gain insight into care processes. Discussion Classification of the objectives, analyses and complementary data used in data-driven care pathway mapping illustrates areas of greater and lesser focus in the literature. The increasing tendency for these methods to find practical application in service redesign is explored across the variety of contexts and research questions identified. A limitation of our approach is that the topic is broad, limiting discussion of ...
    Keywords Care pathway ; Clinical workflow ; Clinical pathway ; Process mining ; Electronic Records ; Review ; Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 310
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

    Kategorien

  2. Article ; Online: Prescriptive variability of drugs by general practitioners.

    Magda Bucholc / Maurice O'Kane / Siobhan Ashe / KongFatt Wong-Lin

    PLoS ONE, Vol 13, Iss 2, p e

    2018  Volume 0189599

    Abstract: Prescription drug spending is growing faster than any other sector of healthcare. However, very little is known about patterns of prescribing and cost of prescribing between general practices. In this study, we examined variation in prescription rates ... ...

    Abstract Prescription drug spending is growing faster than any other sector of healthcare. However, very little is known about patterns of prescribing and cost of prescribing between general practices. In this study, we examined variation in prescription rates and prescription costs through time for 55 GP surgeries in Northern Ireland Western Health and Social Care Trust. Temporal changes in variability of prescribing rates and costs were assessed using the Mann-Kendall test. Outlier practices contributing to between practice variation in prescribing rates were identified with the interquartile range outlier detection method. The relationship between rates and cost of prescribing was explored with Spearman's statistics. The differences in variability and mean number of prescribing rates associated with the practice setting and socioeconomic deprivation were tested using t-test and F-test respectively. The largest between-practice difference in prescribing rates was observed for Apr-Jun 2015, with the number of prescriptions ranging from 3.34 to 8.36 per patient. We showed that practices with outlier prescribing rates greatly contributed to between-practice variability. The largest difference in prescribing costs was reported for Apr-Jun 2014, with the prescription cost per patient ranging from £26.4 to £64.5. In addition, the temporal changes in variability of prescribing rates and costs were shown to undergo an upward trend. We demonstrated that practice setting and socio-economic deprivation accounted for some of the between-practice variation in prescribing. Rural practices had higher between practice variability than urban practices at all time points. Practices situated in more deprived areas had higher prescribing rates but lower variability than those located in less deprived areas. Further analysis is recommended to assess if variation in prescribing can be explained by demographic characteristics of patient population and practice features. Identification of other factors contributing to prescribing variability ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 360
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

    Kategorien

  3. Article ; Online: A hybrid computational approach for efficient Alzheimer’s disease classification based on heterogeneous data

    Xuemei Ding / Magda Bucholc / Haiying Wang / David H. Glass / Hui Wang / Dave H. Clarke / Anthony John Bjourson / Le Roy C. Dowey / Maurice O’Kane / Girijesh Prasad / Liam Maguire / KongFatt Wong-Lin

    Scientific Reports, Vol 8, Iss 1, Pp 1-

    2018  Volume 10

    Abstract: Abstract There is currently a lack of an efficient, objective and systemic approach towards the classification of Alzheimer’s disease (AD), due to its complex etiology and pathogenesis. As AD is inherently dynamic, it is also not clear how the ... ...

    Abstract Abstract There is currently a lack of an efficient, objective and systemic approach towards the classification of Alzheimer’s disease (AD), due to its complex etiology and pathogenesis. As AD is inherently dynamic, it is also not clear how the relationships among AD indicators vary over time. To address these issues, we propose a hybrid computational approach for AD classification and evaluate it on the heterogeneous longitudinal AIBL dataset. Specifically, using clinical dementia rating as an index of AD severity, the most important indicators (mini-mental state examination, logical memory recall, grey matter and cerebrospinal volumes from MRI and active voxels from PiB-PET brain scans, ApoE, and age) can be automatically identified from parallel data mining algorithms. In this work, Bayesian network modelling across different time points is used to identify and visualize time-varying relationships among the significant features, and importantly, in an efficient way using only coarse-grained data. Crucially, our approach suggests key data features and their appropriate combinations that are relevant for AD severity classification with high accuracy. Overall, our study provides insights into AD developments and demonstrates the potential of our approach in supporting efficient AD diagnosis.
    Keywords Medicine ; R ; Science ; Q
    Subject code 006
    Language English
    Publishing date 2018-06-01T00:00:00Z
    Publisher Nature Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

    Kategorien

  4. Article ; Online: Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension

    Mary Ward / Catherine F. Hughes / J. J. Strain / Rosie Reilly / Conal Cunningham / Anne M. Molloy / Geraldine Horigan / Miriam Casey / Kevin McCarroll / Maurice O’Kane / Michael J. Gibney / Albert Flynn / Janette Walton / Breige A. McNulty / Adrian McCann / Laura Kirwan / John M. Scott / Helene McNulty

    BMC Medicine, Vol 18, Iss 1, Pp 1-

    evidence from the JINGO project

    2020  Volume 11

    Abstract: Abstract Background Genome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR ... ...

    Abstract Abstract Background Genome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR co-factor) can lower blood pressure (BP) in hypertensive patients with the variant MTHFR 677TT genotype. We investigated the impact of this common polymorphism on BP throughout adulthood and hypothesised that riboflavin status would modulate the genetic risk of hypertension. Methods Observational data on 6076 adults of 18–102 years were drawn from the Joint Irish Nutrigenomics Organisation project, comprising the Trinity-Ulster Department of Agriculture (TUDA; volunteer sample) and the National Adult Nutrition Survey (NANS; population-based sample) cohorts. Participants were recruited from the Republic of Ireland and Northern Ireland (UK) in 2008–2012 using standardised methods. Results The variant MTHFR 677TT genotype was identified in 12% of adults. From 18 to 70 years, this genotype was associated with an increased risk of hypertension (i.e. systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.07 to 1.90; P = 0.016, after adjustment for antihypertensive drug use and other significant factors, namely, age, male sex, BMI, alcohol and total cholesterol. Low or deficient biomarker status of riboflavin (observed in 30.2% and 30.0% of participants, respectively) exacerbated the genetic risk of hypertension, with a 3-fold increased risk for the TT genotype in combination with deficient riboflavin status (OR 3.00, 95% CI, 1.34–6.68; P = 0.007) relative to the CC genotype combined with normal riboflavin status. Up to 65 years, we observed poorer BP control rates on antihypertensive treatment in participants with the TT genotype (30%) compared to those without this variant, CT (37%) and CC (45%) genotypes (P < 0.027). Conclusions The MTHFR 677TT genotype is associated with higher BP independently of homocysteine and ...
    Keywords Hypertension ; Blood pressure ; Folate polymorphism ; MTHFR ; Riboflavin ; Personalised treatment ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2020-11-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

    Kategorien

  5. Article ; Online: Effect of second booster vaccinations and prior infection against SARS-CoV-2 in the UK SIREN healthcare worker cohortResearch in context

    Peter D. Kirwan / Victoria J. Hall / Sarah Foulkes / Ashley D. Otter / Katie Munro / Dominic Sparkes / Anna Howells / Naomi Platt / Jonathan Broad / David Crossman / Chris Norman / Diane Corrigan / Christopher H. Jackson / Michelle Cole / Colin S. Brown / Ana Atti / Jasmin Islam / Anne M. Presanis / Andre Charlett /
    Daniela De Angelis / Susan Hopkins / Tracy Lewis / Steve Bain / Rebeccah Thomas / John Geen / Carla Pothecary / Sean Cutler / John Northfield / Cathy Price / Johanne Tomlinson / Sarah Knight / Emily Macnaughton / Ekaterina Watson / Rajeka Lazarus / Aaran Sinclair / Joanne Galliford / Bridgett Masunda / Tabitha Mahungu / Alison Rodger / Esther Hanison / Simon Warren / Swati Jain / Mariyam Mirfenderesky / Natasha Mahabir / Rowan Pritchard-Jones / Diane Wycherley / Claire Gabriel / Elijah Matovu / Philippa Bakker / Simantee Guha / S. Gormley / James Pethick / Georgina Butt / Stacey Pepper / Luke Bedford / Paul Ridley / Jane Democratis / Manjula Meda / Anu Chawla / Fran Westwell / Nagesh Kalakonda / Sheena Khanduri / Allison Doel / Sumita Pai / Christian Hacon / Davis Nwaka / Veronica Mendez Moro / A. Moody / Cressida Auckland / Stephanie Prince / Thushan de Silva / Helen Shulver / A. Shah / C. Jones / Banerjee Subhro-Osuji / Angela Houston / Tim Planche / Martin Booth / Christopher Duff / Jonnie Aeron-Thomas / Ray Chaudhuri / David Hilton / Hannah Jory / Zehra'a Al-Khafaji / Philippa Kemsley / Ruth Longfellow / David Boss / Simon Brake / Louise Coke / Ngozi Elumogo / Scott Latham / Chinari Subudhi / Ina Hoad / Claire Thomas / Nihil Chitalia / Tracy Edmunds / Helen Ashby / John Elliott / Beverley Wilkinson / Abby Rand / Catherine Thompson / K. Agwuh / Anna Grice / Kelly Moran / Vijayendra Waykar / Yvonne Lester / Lauren Sach / Kathryn Court / Nikki White / Clair Favager / Kyra Holliday / Jayne Harwood / Brendan Payne / Karen Burns / Lynda Fothergill / Alejandro Arenas-Pinto / Abigail Severn / Kerryanne Brown / Katherine Gray / Jane Dare / Qi Zheng / Kathryn Hollinshead / Robert Shorten / Alun Roebuck / Christopher Holmes / Martin Wiselka / Barzo Faris / Liane Marsh / Clare McAdam / Lisa Ditchfield / Zaman Qazzafi / G. Boyd / N. Wong / Sarah Brand / Jack Squires / John Ashcroft / Ismaelette Del Rosario / Joanne Howard / Emma Ward / Gemma Harrison / Joely Morgan / Claire Corless / Ruth Penn / Nick Wong / Manny Bagary / Nadezda Starkova / Mandy Beekes / Mandy Carnahan / Shivani Khan / Shekoo Mackay / Keneisha Lewis / Graham Pickard / Joy Dawson / Lauren Finlayson / Euan Cameron / Anne Todd / Sebastien Fagegaltier / Sally Mavin / Alexandra Cochrane / Andrew Gibson / Sam Donaldson / Kate Templeton / Martin Malcolm / Beth Smith / Devesh Dhasmana / Susan Fowler / Antonia Ho / Michael Murphy / Claire Beith / Manish Patel / Elizabeth Boyd / Val Irvine / Alison Grant / Rebecca Temple-Purcell / Clodagh Loughrey / Elinor Hanna / Frances Johnston / Angel Boulos / Fiona Thompson / Yuri Protaschik / Susan Regan / Tracy Donaghy / Maurice O'Kane / Omolola Akinbami / Paola Barbero / Tim Brooks / Meera Chand / Ferdinando Insalata / Palak Joshi / Anne-Marie O'Connell / Mary Ramsay / Ayoub Saei / Maria Zambon / Ezra Linley / Simon Tonge / Enemona Adaji / Omoyeni Adebiyi / Nick Andrews / Joanna Conneely / Paul Conneely / Angela Dunne / Simone Dyer / Hannah Emmett / Nipunadi Hettiarachchi / Nishanthan Kapirial / Jameel Khawam / Edward Monk / Sophie Russell / Andrew Taylor-Kerr / Jean Timeyin / Silvia D'Arcangelo / Cathy Rowe / Amanda Semper / Eileen Gallagher / Robert Kyffin / Lisa Cromey / Desmond Areghan / Jennifer Bishop / Melanie Dembinsky / Laura Dobbie / Josie Evans / David Goldberg / Lynne Haahr / Annelysse Jorgenson / Ayodeji Matuluko / Laura Naismith / Desy Nuryunarsih / Alexander Olaoye / Caitlin Plank / Lesley Price / Nicole Sergenson / Sally Stewart / Andrew Telfer / Jennifer Weir / Ellen De Lacy / Yvette Ellis / Susannah Froude / Guy Stevens / Linda Tyson / Susanna Dunachie / Paul Klenerman / Chris Duncan / Rebecca Payne / Lance Turtle / Alex Richter / Thushan De Silva / Eleanor Barnes / Daniel Wootton / Oliver Galgut / Jonathan Heeney / Helen Baxendale / Javier Castillo-Olivares / Rupert Beale / Edward Carr / Wendy Barclay / Maya Moshe / Massimo Palmarini / Brian Willett / John Kenneth Baillie / Jennie Evans / Erika Aquino

    The Lancet Regional Health. Europe, Vol 36, Iss , Pp 100809- (2024)

    1481  

    Abstract: Summary: Background: The protection of fourth dose mRNA vaccination against SARS-CoV-2 is relevant to current global policy decisions regarding ongoing booster roll-out. We aimed to estimate the effect of fourth dose vaccination, prior infection, and ... ...

    Abstract Summary: Background: The protection of fourth dose mRNA vaccination against SARS-CoV-2 is relevant to current global policy decisions regarding ongoing booster roll-out. We aimed to estimate the effect of fourth dose vaccination, prior infection, and duration of PCR positivity in a highly-vaccinated and largely prior-COVID-19 infected cohort of UK healthcare workers. Methods: Participants underwent fortnightly PCR and regular antibody testing for SARS-CoV-2 and completed symptoms questionnaires. A multi-state model was used to estimate vaccine effectiveness (VE) against infection from a fourth dose compared to a waned third dose, with protection from prior infection and duration of PCR positivity jointly estimated. Findings: 1298 infections were detected among 9560 individuals under active follow-up between September 2022 and March 2023. Compared to a waned third dose, fourth dose VE was 13.1% (95% CI 0.9 to 23.8) overall; 24.0% (95% CI 8.5 to 36.8) in the first 2 months post-vaccination, reducing to 10.3% (95% CI −11.4 to 27.8) and 1.7% (95% CI −17.0 to 17.4) at 2–4 and 4–6 months, respectively. Relative to an infection >2 years ago and controlling for vaccination, 63.6% (95% CI 46.9 to 75.0) and 29.1% (95% CI 3.8 to 43.1) greater protection against infection was estimated for an infection within the past 0–6, and 6–12 months, respectively. A fourth dose was associated with greater protection against asymptomatic infection than symptomatic infection, whilst prior infection independently provided more protection against symptomatic infection, particularly if the infection had occurred within the previous 6 months. Duration of PCR positivity was significantly lower for asymptomatic compared to symptomatic infection. Interpretation: Despite rapid waning of protection, vaccine boosters remain an important tool in responding to the dynamic COVID-19 landscape; boosting population immunity in advance of periods of anticipated pressure, such as surging infection rates or emerging variants of concern. Funding: UK ...
    Keywords SARS-CoV-2 ; Vaccine effectiveness ; Asymptomatic ; Symptomatic ; Healthcare worker ; Cohort study ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

    Kategorien

To top