Digital Commons Network^™

Costs Of Single Maintenance And Reliever Therapy Vs Traditional Therapy For Asthma, Tri Pham, Abigail R Barker, Sarah A Eisenstein, Eliot Jost, Anna Volerman, Krutika Chauhan, Ross C Brownson, Timothy Mcbride, Mark D Huffman, Kaharu Sumino, Lynn B Gerald, Mario Castro, Anne E Dixon, James G Krings

2020-Current year OA Pubs

IMPORTANCE: Despite strong guideline support, single maintenance and reliever therapy (SMART) for asthma is underused in the US. Limited insurance coverage of SMART-compatible inhalers remains a major barrier to its adoption.

OBJECTIVE: To compare the annual asthma management costs of SMART vs traditional therapy from a US health care payer perspective.

DESIGN, SETTING, AND PARTICIPANTS: This economic evaluation used a probabilistic decision-tree model with Monte Carlo simulations to compare the total asthma management costs for patients prescribed SMART vs traditional therapy, conducting analyses from September 1, 2024, to March 13, 2025. Input data were extracted through a systematic review of …

Demographic And Clinicopathologic Factors Associated With Colorectal Adenoma Recurrence, Usman Ayub Awan, Qingyuan Song, Kristen K Ciombor, Adetunji T Toriola, Jungyoon Choi, Timothy Su, Xiao-Ou Shu, Kamran Idrees, Kay M Washington, Wei Zheng, Wanqing Wen, Zhijun Yin, Xingyi Guo

2020-Current year OA Pubs

IMPORTANCE: Current colorectal surveillance guidelines emphasize adenoma characteristics but overlook temporal, racial, and sex-based heterogeneity in recurrence risk, a gap that limits equitable and personalized care.

OBJECTIVE: To evaluate the associations of demographic factors, obesity, and adenoma features with recurrence risk over time in a large longitudinal surveillance cohort.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included adults who underwent their first colonoscopic polypectomy between January 1990 and July 2024 at a tertiary medical center.

EXPOSURES: Demographic variables included race and ethnicity, sex, obesity (body mass index >30), family history of colorectal cancer (CRC) or polyps, and age at …

Associations Of Child Amygdala Development With Borderline Personality Symptoms During Adolescence, Anna Constantino-Pettit, Kirsten Gilbert, Kiran Boone, Katherine Luking, Benjamin Geselowitz, Rebecca Tillman, Diana Whalen, Joan Luby, Deanna M Barch, Alecia Vogel

2020-Current year OA Pubs

BACKGROUND: The current understanding of the neural correlates of borderline personality disorder (BPD) is limited, but some evidence suggests that alterations in limbic structures play a role in adult BPD. The developmental course of structural neural differences in BPD is unknown. Whether there is specificity for structural alterations in BPD compared to other psychiatric presentations, such as major depressive disorder (MDD), remains unexplored. In the current study, we examined childhood trajectories of 2 limbic regions that have been implicated in BPD, hippocampal and amygdala volume, as they relate to adolescent BPD symptoms compared to MDD symptoms.

METHODS: Participants (n = …

Risk Factors For Anticoagulant-Related Bleeding In Cancer: Traditional And Cancer-Specific Factors, Alexa Loncharich, Brian F Gage, Suhong Luo, Martin Schoen, Amber Afzal, Amir Mahmoud, Kenneth Carson, Su-Hsin Chang, Yan Yan, Kristen M Sanfilippo

2020-Current year OA Pubs

Managing anticoagulant therapy in cancer-associated venous thromboembolism (VTE) is challenging due to risks of recurrent VTE and anticoagulant-related bleeding. Existing clinical risk models for bleeding are limited by discriminatory ability in patients with cancer, perhaps due to the omission of cancer-specific risk factors for bleeding. This study estimated the associations of traditional and cancer-specific risk factors with bleeding requiring hospitalization in patients with cancer-associated VTE prescribed anticoagulant therapy. We conducted a retrospective cohort study using the Veterans Health Administration database to identify patients with cancer-associated VTE between 2012 and 2020. Cancer-associated VTE was defined by diagnostic International Classification of Diseases …

Management Of Mechanical Ventilation In Emergency Medicine: A Scoping Review, Robert J Klemisch, Mitchell S Hymowitz, Ryan J Alcantara, Brendan F Mullan, Margaret L Davis, Rachel Blume, Nicholas J Johnson, Brian M Fuller

2020-Current year OA Pubs

OBJECTIVES: Invasive mechanical ventilation is used for approximately 250,000 emergency medicine (EM) patients annually and continues to increase. Despite rising volumes, EM clinicians receive limited training in ventilation management. Much of the existing evidence is derived from other environments, which may not fully apply to the unique conditions of EM. This scoping review broadly categorizes literature on invasive ventilation specific to EM patients and clinicians and identifies knowledge gaps to direct future research.

METHODS: Following Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews Checklist guidelines, this review comprehensively mapped the literature on optimizing invasive mechanical ventilation …

Loss Of Beta-Cell Identity And Function As A Mechanism Of Secondary Failure Of Sulfonylurea Therapy In Diabetes, Sumit Patel, Zihan Yan, Maria S Remedi

2020-Current year OA Pubs

Sulfonylureas, commonly used to treat type 2 diabetes (T2D), often lose effectiveness over time when used as monotherapy; however, the underlying mechanisms remain unclear. To investigate the mechanisms of sulfonylurea failure, glibenclamide-releasing pellets were implanted in KK mice, a polygenic model that spontaneously develops T2D. KK mice receiving placebo pellets (KK-Placebo) developed hyperglycemia, hyperinsulinemia, glucose intolerance, and insulin resistance. Notably, KK mice implanted with glibenclamide (KK-Glib) showed improved blood glucose levels during the first 7 days, returning to KK-Placebo levels thereafter. KK-Glib mice exhibited reduced plasma insulin levels and insulin secretion in response to a glucose challenge compared with the …

Silent Messengers In The Nano-World: Harnessing Extracellular Vesicles As Theranostic Tools For Neonatal Surgical Conditions, Augusto Zani

2020-Current year OA Pubs

Extracellular vesicles (EVs) are lipid bilayer-enclosed nanoparticles secreted by all cells that mediate intercellular communication by transferring proteins, lipids, and nucleic acids. Among their cargo, microRNAs are key post-transcriptional regulators of organogenesis. In fetal lung development, EV-mediated signaling is essential for the coordination of epithelial, mesenchymal, endothelial, and immune cells. In congenital diaphragmatic hernia (CDH), disruption of these interactions leads to pulmonary hypoplasia and pulmonary hypertension, the primary causes of morbidity and mortality. Amniotic fluid stem cell-derived EVs (AFSC-EVs) have emerged as a promising cell-free therapy to restore this impaired communication. In rodent, rabbit, and human models of pulmonary hypoplasia, …

How To Measure, Analyze, And Interpret Age-Related Changes In Caenorhabditis Elegans: Lessons For Mechanistic And Evolutionary Theories Of Aging, Zuzana Kocsisova, Brian M Egan, Andrea Scharf, Xavier Anderson, Franziska Pohl, Aaron Anderson, Kerry Kornfeld

2020-Current year OA Pubs

Aging is characterized by progressive degenerative changes in tissue organization and function, some of which increase the probability of mortality. Major goals of aging research are to elucidate the series of events that cause degenerative changes, and to identify environmental, pharmacological, and genetic factors that influence these changes; this information might lead to new strategies to extend health span and lifespan. Mechanistic studies of aging depend on accurate and precise descriptions of age-related changes, since these descriptions define the aging phenotype. Here, we review studies that describe age-related changes in C. elegans, including measurements of integrated functions such as behavior …

Evaluating The Effectiveness Of Escalating To Weekly Adalimumab Dosing For The Treatment Of Noninfectious Uveitis: A Multicenter Study, Shani Pillar, Akshay Thomas, Lynn M Hassman, Howard Chen, Sapna Gangaputra, Laura J Kopplin, Kelly Boyd, Kareem Moussa, Derek C Pham, Keren Chen, Nicholas J Jackson, Edmund Tsui

2020-Current year OA Pubs

PURPOSE: To evaluate the effectiveness of adalimumab dosage escalation in patients with noninfectious uveitis that is controlled inadequately with standard dosing.

DESIGN: Multicenter retrospective interventional case series.

PARTICIPANTS: Patients with noninfectious uveitis receiving active standard biweekly adalimumab dosing who underwent treatment escalation to weekly adalimumab dosing at 6 tertiary referral centers.

METHODS: Demographic data and clinical findings were assessed at the time of adalimumab dosage escalation and 6 months later. Mixed-model analysis was performed to analyze clinical outcomes and to assess predictive factors of success.

MAIN OUTCOME MEASURES: Treatment success composite criteria included: (1) disease quiescence (≤ 0.5+ anterior chamber …

Supporting Emergency Department Patients Experiencing Homelessness, Antony Hsu, Michael A Light, Callan Fockele, Samantha Hay, Stephen Y Liang, Wendy Macias-Konstantopoulos, Carla B Brim, William Weber

2020-Current year OA Pubs

Homelessness is a growing public health crisis across the United States. Emergency physicians are uniquely positioned to address immediate medical concerns and the underlying social drivers of health for patients experiencing homelessness. Initiating coordination of care in the emergency department addresses their hierarchy of needs and can help support patient movement through the department. Practice adaptations described include early engagement; trauma-informed care approach; addressing unmet nonmedical needs; establishing safe dispositions; documenting homelessness, substance use disorder, and linkages to care; clinical practice adaptations; and palliative care approaches. Programs and initiatives outside of the emergency department described include street medicine and government …

A Female With Missing Anatomical Landmarks During Emergency Endotracheal Intubation, Matthew P Olocco, Rawan Safa, Philip A Mudd, Aaron J Lacy

2020-Current year OA Pubs

No abstract provided.

The Death To Onchocerciasis And Lymphatic Filariasis (Dolf) Project: Accomplishments And Ongoing Research, Peter U. Fischer, Christopher L. King, Philip J. Budge, Gary J. Weil, Dolf Consortium

2020-Current year OA Pubs

The Death to Onchocerciasis and Lymphatic Filariasis (DOLF) project conducts clinical and translational research to accelerate the global elimination of lymphatic filariasis (LF) and onchocerciasis (river blindness). Research needs were identified during several meetings of experts and helped study design. Over the last 15 years the project has conducted mass drug administration (MDA) studies and clinical trials with outstanding research teams in 11 countries that have led to many important discoveries. For example, DOLF studies showed that annual MDA was as effective as semiannual MDA for LF elimination and that semiannual MDA with albendazole alone can eliminate LF in areas …

Divergent Humoral Immune Signatures In Response To Klebsiella Pneumoniae Bacteremia, Paeton L Wantuch, Nadia Wattad, David A Rosen

2020-Current year OA Pubs

OBJECTIVES: Klebsiella pneumoniae is an increasingly threatening global pathogen with high rates of antibiotic resistance and no licensed vaccines available. Despite its worldwide importance, little is known about the human adaptive immune response to K. pneumoniae infection.

METHODS: Herein we observed the longitudinal antibody responses of three immunocompetent patients hospitalized with K. pneumoniae bacteremia. We analyzed the human serum for antibody titers and in vitro functionality. Further, serum function was evaluated via an in vivo mouse model.

RESULTS: We found that in each case, anti-K. pneumoniae antibodies against the infecting strain were still detectable a year after the initial infection. …

Palbociclib With Adjuvant Endocrine Therapy In Early Breast Cancer: 5-Year Follow-Up Analysis Of The Global Multicenter, Open-Label, Randomized Phase Iii Pallas Trial (Abcsg-42/Aft-05/Pre0109/Big-14-13), E L Mayer, K Clifton, Et Al.

2020-Current year OA Pubs

BACKGROUND: In the phase III PALLAS trial, the addition of 2 years of palbociclib to adjuvant endocrine therapy (ET) did not improve short-term invasive disease-free survival (iDFS) compared with ET alone in high-risk early-stage hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. In this article, we report 5-year efficacy outcomes, including updated iDFS and overall survival (OS).

PATIENTS AND METHODS: PALLAS is an international, open-label, randomized phase III trial evaluating the addition of 2 years of palbociclib to adjuvant ET in patients with stage II-III HR-positive/HER2-negative breast cancer. The primary endpoint was iDFS.

RESULTS: The trial enrolled …

Patient-Reported Outcomes In The Serena-6 Trial Of Camizestrant Plus Cdk4/6 Inhibitor In Patients With Advanced Breast Cancer And Emergent Esr1 Mutations During First-Line Endocrine-Based Therapy, E L Mayer, C Ma, Et Al.

2020-Current year OA Pubs

BACKGROUND: In SERENA-6, switching from aromatase inhibitor (AI) to camizestrant with continuation of CDK4/6 inhibitor (CDK4/6i) guided by emergence of ESR1 mutations (ESR1-mut) during first-line AI-CDK4/6i in patients with hormone receptor (HR)-positive advanced breast cancer (ABC) resulted in statistically significant and clinically meaningful improvement in progression-free survival compared with AI-CDK4/6i and reduction in the risk of deterioration in global health status (GHS)/quality of life (QoL) (hazard ratio 0.54). Here we report additional data from patient-reported outcomes (PROs).

PATIENTS AND METHODS: Patients completed PRO questionnaires at pre-specified timepoints, including the European Organisation for Research and Treatment of Cancer (EORTC) oncology-specific EORTC …

Intersecting Challenges: Substance Use And Mental Health Disparities Across Self-Reported Disability Status, Jessica Williams, Xiao Li, Hannah S Szlyk, Erin Kasson, Nathaniel A Dell, Alex Ramsey, Patricia A Cavazos-Rehg

2020-Current year OA Pubs

PURPOSE: Substance use and substance use disorders (SUD) disproportionately affect people with disabilities (PWD), yet PWD remain under-represented in addiction treatment literature. While recent work has begun to address SUD prevalence and recovery service gaps, little is known about how disability status shapes substance use outcomes. The present study is the first to our knowledge to investigate how recovery, mental health comorbidities, and barriers to care differ across disability status using structured survey data from people who use substances.

METHODS: 333 participants who use substances and provided information about their disability status in the baseline survey for a digital intervention …

"Another One Bite The Dust-It Happens So Much In Black Neighborhoods": Structural Barriers And Grassroots Resources Among Black Men Who Use Drugs Facing Fentanyl-Era Overdose And Treatment Disparities, Devin E Banks, Kaytryn D Campbell, Maria E Paschke, Rashmi Ghonasgi, Bridget Coffey, Jameala Jones, Brittany Blanchard, Ryan W Carpenter, Daje Bradshaw, Rachel P Winograd

2020-Current year OA Pubs

INTRODUCTION: Black men in the United States have been disproportionately impacted by fatal drug overdose since the proliferation of synthetic opioids like fentanyl. This community based participatory research study examined determinants of overdose risk and substance use treatment disparities among Black men based on their lived experience.

METHODS: Between February and December 2023, we enrolled 35 Black men reporting past-30-day opioid use to complete semi-structured qualitative interviews. Interviews were analyzed by a team of academic and community-based coders with lived experience using an inductive-deductive approach to thematic analysis.

RESULTS: Six key themes were identified. Four themes described racism-related inequities posing …

Ultrasound Applications In The Treatment Of Major Depressive Disorder: A Systematic Review Of Techniques And Therapeutic Potentials In Clinical Trials And Animal Model Studies, Gansheng Tan, Hong Chen, Eric C Leuthardt

2020-Current year OA Pubs

OBJECTIVE: Major depressive disorder (MDD) is a debilitating condition that inflicts significant personal and economic burdens and affects approximately 8% of the US population. Approximately 30% of patients with MDD do not respond to conventional antidepressant and psychotherapeutic treatments. Current treatment options for refractory MDD include transcranial magnetic stimulation (TMS) and invasive surgical procedures such as surgical ablation, vagus nerve stimulation, and deep brain stimulation. In this context, therapeutic ultrasound emerges as a promising alternative for treating refractory MDD, which has the unique advantage of combining noninvasiveness with selective targeting. Over the past ten years, there has been growth in …

Analysis Of Pediatric Cervical Spine Injury Evaluation Workflow In The Emergency Department, Annie J Truelove, Megan E Gregory, Fahd A Ahmad, Sean P Pajak, Nicole C Hammer, Daniel Corwin, Leah Tzimenatos, Scott O King, Matthew Szadkowski, Martin J Herman, Julie C Leonard

2020-Current year OA Pubs

OBJECTIVES: The decision to image children for cervical spine injuries (CSI), an uncommon injury with high associated morbidity and mortality, is complex. X-rays and computed tomography are often used to screen for CSI; however, radiation exposure increases lifetime cancer risk. We recently developed a CSI prediction rule to inform pediatric imaging decisions. To guide implementation, we conducted a workflow analysis of CSI screening in children after blunt trauma.

METHODS: We interviewed emergency departments (ED) and trauma clinicians at 21 hospitals following the applied cognitive task analysis task diagram, knowledge audit, and simulation interview approaches. Interviews were coded using a combined …

Seeg-Guided Responsive Neurostimulation To Treat Neocortical Epilepsy: A Multicenter Retrospective Study Of The Efficacy And Safety Of Depth Electrode-Mediated Neuromodulation, Sina Sadeghzadeh, Jon T Willie, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Pivotal trials have established the effectiveness of the Responsive Neurostimulation System (RNS® System) in treating focal epilepsy. In clinical trials, depth leads were primarily used to treat mesial temporal seizure onsets while cortical strip leads were used to treat neocortical seizure onsets. Here, we systematically analyze the safety and efficacy of stereoelectroencephalography (sEEG)-guided depth leads to provide responsive stimulation to neocortical gray matter.

METHODS: Patients were stratified as strong responders (>median cohort seizure reduction %), weak responders (>0% and ≤median cohort seizure reduction %), and anti-responders (≤0%) based on percent seizure reduction at 1 year post-implant (1-Y). …

Association Of Sleep Disturbance With Survival After Colorectal Cancer Diagnosis: Results From The Colocare Study, Anita R Peoples, Adetunji T Toriola, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Sleep problems are common among cancer patients. The relationship between sleep disruption and clinical outcomes after colorectal cancer (CRC) diagnosis remains poorly understood. We investigated associations of sleep disruption with survival and recurrence in patients with CRC.

METHODS: CRC patients with stages I-IV (N = 895) were included in this study. Self-reported sleep disturbance was assessed presurgery using the sleep item from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core-30 and classified into "no/mild" or "moderate/severe" sleep disturbance. Cox-proportional hazard models were computed (HRs and 95% confidence intervals) to investigate associations of sleep disturbance …

Accelerated Diffusion Basis Spectrum Imaging With Tensor Computations, Kainen L Utt, Jacob S Blum, Donsub Rim, Sheng-Kwei Song

2020-Current year OA Pubs

This paper introduces an advanced framework for accelerated processing of diffusion-weighted imaging (DWI) data that utilizes an entire-image modeling approach to optimize the estimation of diffusion parameters from DWIs by mapping input diffusion data to predicted signals and estimating parameter values via a stochastic gradient descent optimizer (Adam). To validate this approach, we applied this framework to diffusion basis spectrum imaging (DBSI) and analyzed in vivo human brain and ex vivo mouse brain DWIs. Results demonstrate significant improvements to computational speed and signal-to-noise ratio (SNR) in estimated parameter maps compared to standard DBSI. Our approach is applicable to any diffusion …

Association Of Self-Rated Health And Risk Of Incident Atrial Fibrillation: Findings From Three Cohorts, Parveen K Garg, Aniqa Alam, Harpreet S Bhatia, Jens Horn, Vegard Malmo, Jan Pal Loennechen, Scott Mu, Randi Foraker, Elizabeth Selvin, Imre Janszky, Susan R Heckbert, Alvaro Alonso

2020-Current year OA Pubs

BACKGROUND: Self-rated health (SRH) is easy to obtain and is known to be a good predictor for mortality and several comorbidities, including cardiovascular disease, but its relation to atrial fibrillation (AF) is largely unknown. We determined the association of SRH with risk of developing AF.

METHODS: We conducted a pooled cohort analysis of participants in the Atherosclerosis Risk in Communities Study (ARIC) (

RESULTS: Over a mean of 16±6, 9 ± 2, and 10±4 years of follow-up, 2340 (22.8 %), 1525 (3.5 %), and 879 (17.4 %) incident AF events occurred in ARIC, HUNT-3, and MESA respectively. Lower SRH categories …

Skida1 Sustains Mll::Enl-Expressing Hematopoietic Progenitors During Neonatal Stages And Promotes B-Lineage Priming, Jonny Mendoza-Castrejon, Wei Yang, Elisabeth Denby, Rohini Muthukumar, Emily B Casey, Riddhi M Patel, Sarah K Tasian, Jeffrey A Magee

2020-Current year OA Pubs

Infant leukemias arise as B-cell acute lymphoblastic or acute myeloid leukemia. Most are driven by chromosomal rearrangements of the

Plasma Ceramides Levels In Severe Covid-19 Disease: Correlations With Survival, Tri Pham, Andrea M Heredia Castillo, Andrew Atkinson, Linda R Peterson, M Cristina Vazquez Guillamet

2020-Current year OA Pubs

BACKGROUND: Dysregulated inflammatory processes have been associated with severe COVID-19 disease. Ceramides, bioactive lipids involved in inflammatory signaling, have been utilized to predict outcomes in chronic cardiometabolic diseases and pancreatic cancer, but their role in COVID-19 remains unknown.

METHODS: This observational study prospectively enrolled patients with COVID-19 disease who required intubation and mechanical ventilation at a Midwestern academic hospital between August 2020 and March 2021. Plasma ceramides 16:0 (C16), 22:0 (C22), and 24:0 (C24) and inflammatory markers (CRP, ESR, D-Dimer, and ferritin) were collected and organized weekly from symptom onset for up to 6 weeks. Patients were grouped by in-hospital …

Nested Ecosystems Theory For Conceptualizing Brain Tumors, Lori A Forster, David H Gutmann

2020-Current year OA Pubs

The application of advanced multi-omic methodologies to studying brain tumors has culminated in the appreciation that these cancers function as ecosystems that depend on the interactions of a diverse collection of cell types and signals. This connectivity operates not only at the level of the cancer cell, in which variants create new growth dependencies, but also between tumor cells and the immediate tumor microenvironment, between tumor cells and cell populations residing elsewhere in the brain tissue or body, and in response to extracorporeal factors. The cellular and molecular relationships within these four interrelated strata (intracellular, extracellular, intracorporeal and extracorporeal) act …

Phase 1 Study Of Inbrx-105, A Tnfrsf9 (4-1bb) And Pd-L1 Bispecific Antibody, In Patients With Select Solid Tumors, Jong Chul Park, Doug R Adkins, Et Al.

2020-Current year OA Pubs

PURPOSE: INBRX-105, a tetravalent, PD-L1-targeted TNFRSF9 (4-1BB) agonist, demonstrated preclinical antitumor activity. This first-in-human study evaluated INBRX-105 in solid tumors.

PATIENTS AND METHODS: This open-label, 4-part, phase 1 study evaluated INBRX-105 alone or with pembrolizumab in adults with locally advanced/metastatic, unresectable solid tumors (NCT03809624). INBRX-105 was administered intravenously once every 2 weeks or 4 weeks in parts 1 (single-agent dose escalation; 0.001-3 mg/kg) and 2 (single-agent expansion) or once every 3 weeks in parts 3 (combination dose escalation; INBRX-105 0.03-1.0 mg/kg) and 4 (combination expansion). Part 2 enrolled patients with checkpoint inhibitor-relapsed/refractory (CPI-R/R) tumors. Part 4 enrolled patients with CPI-R/R …

Lightweight Open-Source Large Language Models Versus Ctakes For Information Extraction From Discharge Summaries: Tobacco Smoking Status Test Case, David M Dávila-García, Matthew J Schuelke, Adam B Wilcox

2020-Current year OA Pubs

OBJECTIVES: To compare lightweight open-source large language models (LLMs) with cTAKES, a state-of-the-art natural language processing (NLP) system, in an information extraction task from hospitalization discharge summaries.

MATERIALS AND METHODS: Two readers annotated 250 randomly sampled adult discharge summaries (BJC HealthCare, 2018-2023) for tobacco smoking status as "Smoker," "Never smoker," "Unknown." Six LLMs (Llama-3 [1B-70B], gpt-oss-20B, MedGemma-27B) and cTAKES extracted smoking status from summaries. Performance was benchmarked against consensus annotations using weighted F1-score, macro F1-score, and per-class F1-scores and a noninferiority test.

RESULTS: Inter-reader agreement was excellent (κ = 0.91). LLM size (2.3-47.3 GB) and inference time (2.5-14.5 s/note) varied. …

Effects Of Dual-Eligible Integrated Care Plans On Medicaid Enrollment And Retention: Evidence From The Implementation Of Medicare-Medicaid Plans, Eric T Roberts, Eliza Macneal, Kenton J Johnston, José F Figueroa

2020-Current year OA Pubs

Medicare and Medicaid are separate programs that together cover 13 million low-income older adults and people with disabilities, known as dual-eligible individuals. Concern about a lack of coordination across Medicare and Medicaid has prompted the development of Integrated Care Programs (ICPs). Although the primary goal of ICPs is to coordinate financing and care across Medicare and Medicaid, ICPs may also influence whether low-income individuals obtain or keep Medicaid. We evaluated whether the rollout of Medicare-Medicaid Plans (MMPs)-one of the largest ICPs-was associated with changes in Medicaid take-up and retention among Medicare beneficiaries residing in high-poverty zip codes. Using a stacked …

Phenofit: A Framework For Determining Computable Phenotyping Algorithm Fitness For Purpose And Reuse, Laura K Wiley, Luke V Rasmussen, Rebecca T Levinson, Jennnifer Malinowski, Sheila M Manemann, Melissa P Wilson, Martin Chapman, Jennifer A Pacheco, Theresa L Walunas, Justin B Starren, Suzette J Bielinski, Rachel L Richesson

2020-Current year OA Pubs

BACKGROUND: Computational phenotyping from electronic health records (EHRs) is essential for clinical research, decision support, and quality/population health assessment, but the proliferation of algorithms for the same conditions makes it difficult to identify which algorithm is most appropriate for reuse.

OBJECTIVE: To develop a framework for assessing phenotyping algorithm fitness for purpose and reuse.

FITNESS FOR PURPOSE: Phenotyping algorithms are fit for purpose when they identify the intended population with performance characteristics appropriate for the intended application.

FITNESS FOR REUSE: Phenotyping algorithms are fit for reuse when the algorithm is implementable and generalizable-that is, it identifies the same intended population …