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  • 1
    Online Resource
    Online Resource
    Use of Medicare Claims to Rank Hospitals by Surgical Site Infection Risk following Coronary Artery Bypass Graft Surgery
    Cambridge University Press (CUP) ; 2011
    In:  Infection Control & Hospital Epidemiology Vol. 32, No. 8 ( 2011-08), p. 775-783
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 32, No. 8 ( 2011-08), p. 775-783
    Abstract: To evaluate whether longitudinal insurer claims data allow reliable identification of elevated hospital surgical site infection (SSI) rates. Design. We conducted a retrospective cohort study of Medicare beneficiaries who underwent coronary artery bypass grafting (CABG) in US hospitals performing at least 80 procedures in 2005. Hospitals were assigned to deciles by using case mix–adjusted probabilities of having an SSI-related inpatient or outpatient claim code within 60 days of surgery. We then reviewed medical records of randomly selected patients to assess whether chart-confirmed SSI risk was higher in hospitals in the worst deciles compared with the best deciles. Participants. Fee-for-service Medicare beneficiaries who underwent CABG in these hospitals in 2005. Results. We evaluated 114,673 patients who underwent CABG in 671 hospitals. In the best decile, 7.8% (958/12,307) of patients had an SSI-related code, compared with 24.8% (2,747/11,068) in the worst decile ( P 〈 .001). Medical record review confirmed SSI in 40% (388/980) of those with SSI-related codes. In the best decile, the chart-confirmed annual SSI rate was 3.2%, compared with 9.4% in the worst decile, with an adjusted odds ratio of SSI of 2.7 (confidence interval, 2.2–3.3; P 〈 .001) for CABG performed in a worst-decile hospital compared with a best-decile hospital. Conclusions. Claims data can identify groups of hospitals with unusually high or low post-CABG SSI rates. Assessment of claims is more reproducible and efficient than current surveillance methods. This example of secondary use of routinely recorded electronic health information to assess quality of care can identify hospitals that may benefit from prevention programs.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/660874
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2011
    detail.hit.zdb_id: 2106319-9
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  • 2
    Online Resource
    Online Resource
    16Up: Outline of a Study Investigating Wellbeing and Information and Communication Technology Use in Adolescent Twins
    Cambridge University Press (CUP) ; 2020
    In:  Twin Research and Human Genetics Vol. 23, No. 6 ( 2020-12), p. 345-357
    Details
    In: Twin Research and Human Genetics, Cambridge University Press (CUP), Vol. 23, No. 6 ( 2020-12), p. 345-357
    Abstract: The ‘16Up’ study conducted at the QIMR Berghofer Medical Research Institute from January 2014 to December 2018 aimed to examine the physical and mental health of young Australian twins aged 16−18 years ( N = 876; 371 twin pairs and 18 triplet sets). Measurements included online questionnaires covering physical and mental health as well as information and communication technology (ICT) use, actigraphy, sleep diaries and hair samples to determine cortisol concentrations. Study participants generally rated themselves as being in good physical (79%) and mental (73%) health and reported lower rates of psychological distress and exposure to alcohol, tobacco products or other substances than previously reported for this age group in the Australian population. Daily or near-daily online activity was almost universal among study participants, with no differences noted between males and females in terms of frequency or duration of internet access. Patterns of ICT use in this sample indicated that the respondents were more likely to use online information sources for researching physical health issues than for mental health or substance use issues, and that they generally reported partial levels of satisfaction with the mental health information they found online. This suggests that internet-based mental health resources can be readily accessed by adolescent Australians, and their computer literacy augurs well for future access to online health resources. In combination with other data collected as part of the ongoing Brisbane Longitudinal Twin Study, the 16Up project provides a valuable resource for the longitudinal investigation of genetic and environmental contributions to phenotypic variation in a variety of human traits.
    Type of Medium: Online Resource
    ISSN: 1832-4274 , 1839-2628
    URL: Article
    DOI: 10.1017/thg.2020.83
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2184274-7
    SSG: 12
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  • 3
    Online Resource
    Online Resource
    Exome Sequencing to Detect Rare Variants Associated With General Cognitive Ability: A Pilot Study
    Cambridge University Press (CUP) ; 2015
    In:  Twin Research and Human Genetics Vol. 18, No. 2 ( 2015-04), p. 117-125
    Details
    In: Twin Research and Human Genetics, Cambridge University Press (CUP), Vol. 18, No. 2 ( 2015-04), p. 117-125
    Abstract: Variation in human cognitive ability is of consequence to a large number of health and social outcomes and is substantially heritable. Genetic linkage, genome-wide association, and copy number variant studies have investigated the contribution of genetic variation to individual differences in normal cognitive ability, but little research has considered the role of rare genetic variants. Exome sequencing studies have already met with success in discovering novel trait-gene associations for other complex traits. Here, we use exome sequencing to investigate the effects of rare variants on general cognitive ability. Unrelated Scottish individuals were selected for high scores on a general component of intelligence ( g ). The frequency of rare genetic variants (in n = 146) was compared with those from Scottish controls (total n = 486) who scored in the lower to middle range of the g distribution or on a proxy measure of g . Biological pathway analysis highlighted enrichment of the mitochondrial inner membrane component and apical part of cell gene ontology terms. Global burden analysis showed a greater total number of rare variants carried by high g cases versus controls, which is inconsistent with a mutation load hypothesis whereby mutations negatively affect g . The general finding of greater non-synonymous (vs. synonymous) variant effects is in line with evolutionary hypotheses for g . Given that this first sequencing study of high g was small, promising results were found, suggesting that the study of rare variants in larger samples would be worthwhile.
    Type of Medium: Online Resource
    ISSN: 1832-4274 , 1839-2628
    URL: Article
    DOI: 10.1017/thg.2015.10
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2184274-7
    SSG: 12
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  • 4
    Online Resource
    Online Resource
    Genetic Specificity of Hippocampal Subfield Volumes, Relative to Hippocampal Formation, Identified in 2148 Young Adult Twins and Siblings
    Cambridge University Press (CUP) ; 2022
    In:  Twin Research and Human Genetics Vol. 25, No. 3 ( 2022-06), p. 129-139
    Details
    In: Twin Research and Human Genetics, Cambridge University Press (CUP), Vol. 25, No. 3 ( 2022-06), p. 129-139
    Abstract: The hippocampus is a complex brain structure with key roles in cognitive and emotional processing and with subregion abnormalities associated with a range of disorders and psychopathologies. Here we combine data from two large independent young adult twin/sibling cohorts to obtain the most accurate estimates to date of genetic covariation between hippocampal subfield volumes and the hippocampus as a single volume. The combined sample included 2148 individuals, comprising 1073 individuals from 627 families (mean age = 22.3 years) from the Queensland Twin IMaging (QTIM) Study, and 1075 individuals from 454 families (mean age = 28.8 years) from the Human Connectome Project (HCP). Hippocampal subfields were segmented using FreeSurfer version 6.0 (CA4 and dentate gyrus were phenotypically and genetically indistinguishable and were summed to a single volume). Multivariate twin modeling was conducted in OpenMx to decompose variance into genetic and environmental sources. Bivariate analyses of hippocampal formation and each subfield volume showed that 10%–72% of subfield genetic variance was independent of the hippocampal formation, with greatest specificity found for the smaller volumes; for example, CA2/3 with 42% of genetic variance being independent of the hippocampus; fissure (63%); fimbria (72%); hippocampus-amygdala transition area (41%); parasubiculum (62%). In terms of genetic influence, whole hippocampal volume is a good proxy for the largest hippocampal subfields, but a poor substitute for the smaller subfields. Additive genetic sources accounted for 49%–77% of total variance for each of the subfields in the combined sample multivariate analysis. In addition, the multivariate analyses were sufficiently powered to identify common environmental influences (replicated in QTIM and HCP for the molecular layer and CA4/dentate gyrus, and accounting for 7%–16% of total variance for 8 of 10 subfields in the combined sample). This provides the clearest indication yet from a twin study that factors such as home environment may influence hippocampal volumes (albeit, with caveats).
    Type of Medium: Online Resource
    ISSN: 1832-4274 , 1839-2628
    URL: Article
    DOI: 10.1017/thg.2022.20
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2184274-7
    SSG: 12
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