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  • 1
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: Background: The Assessing the Burden of Diabetes by Type in Children, Adolescents and Young Adults (DiCAYA) Network aims to provide timely estimates of diabetes prevalence and incidence using large scale electronic health record (EHR) data. However, patients who self-select into health systems are likely to differ demographically and by health status than the overall source population of interest, which could limit the generalizability of surveillance estimates. Methods: Using simulations, we evaluated the potential of established bias correction methods (inverse probability weighting, post stratification, raking and multilevel regression with post stratification (MRP)) to mitigate selection biases within EHR data. The EHR sample was assumed to have overrepresentation of younger, higher socioeconomic status (SES) and white individuals than the source. Simulations varied the selection processes (e.g. dependent on diabetes status) and misspecification in the adjustment methods. The performance of each method was assessed as the absolute difference between the estimated prevalence in the sample and true prevalence in the simulated source. Results: When selection was dependent on demographics alone, the mean bias in the crude prevalence estimate was -0.7 percentage points (pp) . Each method performed well in removing this bias when demographics that affected selection were adequately accounted for. Biases remained when SES was misclassified in the adjustment process, with best performance seen for MRP (-0.5 pp) . When selection was dependent on diabetes status, the mean bias in the crude prevalence estimate was 1.3 pp and each method similarly worsened this bias (2.3 pp) . Conclusions: These methods are easy to implement and can provide reliable surveillance estimates if factors that are associated with selection into the EHR can be accounted for. However, novel methods may be needed when selection is dependent on diabetes status or other unmeasured factors. Disclosure S.Conderino: None. M.Rosenman: None. V.W.Zhong: None. K.Reynolds: Research Support; Amgen Inc., Merck & Co., Inc., Novartis Pharmaceuticals Corporation. S.Park: None. L.H.Utidjian: None. J.Divers: None. R.Anthopolos: None. L.Thorpe: None. B.Cai: None. H.Shao: Board Member; BRAVO4HEALTH, LLC. T.C.Ong: None. T.L.Crume: None. B.S.Schwartz: None. H.Kirchner: None. Funding Centers for Disease Control and Prevention (1 U18DP006633-01-00)
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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  • 2
    In: Neonatology, S. Karger AG, Vol. 91, No. 1 ( 2007), p. 28-35
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Neonates exposed to mechanical ventilation may develop bronchopulmonary dysplasia (BPD). BPD neonates exhibit a 25–30% increase in energy expenditure which may decrease the rate of growth and development. Heliox has been shown to improve pulmonary function and may decrease energy expenditure. We hypothesized that heliox would provide a safe environment for sustained growth and development. 〈 i 〉 Objective: 〈 /i 〉 To assess the safety of the heliox environment we observed developmental milestones; recorded changes in weight, total length, limb length and head circumference; measured blood chemistries; compared primary organ and muscle weights, and analyzed muscle enzymatic activity. 〈 i 〉 Design/Methods: 〈 /i 〉 Four-day-old rabbit pups (n = 27) were randomized into control (21% O 〈 sub 〉 2 〈 /sub 〉 ; 79% N 〈 sub 〉 2 〈 /sub 〉 ) or heliox (21% O 〈 sub 〉 2 〈 /sub 〉 ; 79% He) groups, then raised for 14 days at 26.7°C and 50% relative humidity. Pups were euthanized on day 14, blood drawn and primary organs, diaphragm and gastrocnemius weighed and snap-frozen. 〈 i 〉 Results: 〈 /i 〉 All pups thrived in both environments, achieving expected developmental milestones. There were no physiologically significant group differences in weight, growth factors, tissue weight, blood chemistry or muscle enzyme activity. 〈 i 〉 Conclusions: 〈 /i 〉 No observed long-term differences in growth or development. Results demonstrated that long-term heliox exposure is safe in this rabbit model. These data suggest that heliox administration may provide time for pulmonary improvement in the BPD population, warranting appropriate clinical trials.
    Type of Medium: Online Resource
    ISSN: 1661-7800 , 1661-7819
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 2403535-X
    SSG: 12
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  • 3
    In: American Journal of Medical Quality, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 2 ( 2020-03), p. 177-185
    Abstract: Measures of health care quality are produced from a variety of data sources, but often, physicians do not believe these measures reflect the quality of provided care. The aim was to assess the value to health system leaders (HSLs) and parents of benchmarking on health care quality measures using data mined from the electronic health record (EHR). Using in-context interviews with HSLs and parents, the authors investigated what new decisions and actions benchmarking using data mined from the EHR may enable and how benchmarking information should be presented to be most informative. Results demonstrate that although parents may have little experience using data on health care quality for decision making, they affirmed its potential value. HSLs expressed the need for high-confidence, validated metrics. They also perceived barriers to achieving meaningful metrics but recognized that mining data directly from the EHR could overcome those barriers. Parents and HSLs need high-confidence health care quality data to support decision making.
    Type of Medium: Online Resource
    ISSN: 1062-8606 , 1555-824X
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2181248-2
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  • 4
    In: eGEMs (Generating Evidence & Methods to improve patient outcomes), Ubiquity Press, Ltd., Vol. 7, No. 1 ( 2019-08-01), p. 36-
    Abstract: Background: Clinical data research networks (CDRNs) aggregate electronic health record data from multiple hospitals to enable large-scale research. A critical operation toward building a CDRN is conducting continual evaluations to optimize data quality. The key challenges include determining the assessment coverage on big datasets, handling data variability over time, and facilitating communication with data teams. This study presents the evolution of a systematic workflow for data quality assessment in CDRNs.Implementation: Using a specific CDRN as use case, the workflow was iteratively developed and packaged into a toolkit. The resultant toolkit comprises 685 data quality checks to identify any data quality issues, procedures to reconciliate with a history of known issues, and a contemporary GitHub-based reporting mechanism for organized tracking.Results: During the first two years of network development, the toolkit assisted in discovering over 800 data characteristics and resolving over 1400 programming errors. Longitudinal analysis indicated that the variability in time to resolution (15day mean, 24day IQR) is due to the underlying cause of the issue, perceived importance of the domain, and the complexity of assessment.Conclusions: In the absence of a formalized data quality framework, CDRNs continue to face challenges in data management and query fulfillment. The proposed data quality toolkit was empirically validated on a particular network, and is publicly available for other networks. While the toolkit is user-friendly and effective, the usage statistics indicated that the data quality process is very time-intensive and sufficient resources should be dedicated for investigating problems and optimizing data for research.
    Type of Medium: Online Resource
    ISSN: 2327-9214
    Language: Unknown
    Publisher: Ubiquity Press, Ltd.
    Publication Date: 2019
    detail.hit.zdb_id: 2734659-6
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  • 5
    In: Journal of Asthma, Informa UK Limited, Vol. 54, No. 10 ( 2017-11-26), p. 1051-1058
    Type of Medium: Online Resource
    ISSN: 0277-0903 , 1532-4303
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2017
    detail.hit.zdb_id: 2043248-3
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  • 6
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: The Assessing the Burden of Diabetes by Type in Children, Adolescents, and Young Adults (DiCAYA) Network, a CDC/NIDDK-funded collaborative, aims to create a multi-site electronic health record (EHR) -based diabetes surveillance system. Foundational to the network's efforts is the development of a computable phenotype (CP) algorithm that can identify cases of diabetes. To advance the mission of the DiCAYA network, University of Florida (UF) Health system researchers developed a pilot CP algorithm for identifying diabetes cases in youth. The CP algorithm was iteratively derived based on structured data from EHRs (UF Health system 2012-2020) . We randomly selected 500 presumed cases among individuals & lt; 18 years old who has (1) HbA1c ≥ 6.5%; or (2) fasting glucose ≥ 126 mg/dL; or (3) random plasma glucose ≥ 200 mg/dL; or (4) diabetes-related diagnosis code from an inpatient or outpatient encounter; or (5) prescribed, administered, or dispensed diabetes-related medication. Four reviewers independently reviewed the patient charts to determine diabetes status and type. Presumed cases without type 1 (T1D) or type 2 (T2D) diabetes diagnosis codes were categorized as nondiabetes or other types. The rest were categorized as T1D if the ratio of T1D codes to the sum of T1D and T2D codes was ≥ 0.5, or otherwise categorized as T2D. Next, we applied a list of diagnoses and procedures that can determine diabetes type (e.g., steroid use suggests induced diabetes) to correct misclassifications from step 1. Among the 500 reviewed cases, 159 and 64 had T1D and T2D. The sensitivity, specificity, and positive predictive values of the CP algorithm were 94%, 98%, and 96% for T1D; 95%, 95%, and 73% for T2D. We developed a highly accurate EHR-based CP for diabetes in youth based on EHR data from UF Health. Consistent with prior studies, T2D was more difficult to identify using these methods. A DiCAYA-wide validation and algorithm refinement process will be conducted. Disclosure P.Li: None. M.Prosperi: None. B.E.Dixon: Advisory Panel; Merck Sharp & Dohme Corp. D.Dabelea: None. L.H.Utidjian: None. T.L.Crume: None. L.Thorpe: None. A.D.Liese: None. D.Schatz: Advisory Panel; Abbott Diabetes, Medtronic. M.A.Atkinson: None. M.J.Haller: Advisory Panel; SAB Biotherapeutics , Consultant; MannKind Corporation, Sanofi. E.Spector: None. E.Shenkman: None. J.Bian: None. Y.Guo: None. H.Shao: Board Member; BRAVO4HEALTH, LLC. M.A.Atkinson: None. K.Alkhuzam: None. R.S.Patel: None. W.T.Donahoo: None. S.Bost: None. T.Lyu: None. Y.Wu: None. W.Hogan: None. Funding CDC/NIDDK U18DP006512
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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  • 7
    Online Resource
    Online Resource
    Elsevier BV ; 2004
    In:  Biochemical and Biophysical Research Communications Vol. 319, No. 4 ( 2004-07), p. 1132-1137
    In: Biochemical and Biophysical Research Communications, Elsevier BV, Vol. 319, No. 4 ( 2004-07), p. 1132-1137
    Type of Medium: Online Resource
    ISSN: 0006-291X
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2004
    detail.hit.zdb_id: 1461396-7
    SSG: 12
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