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Quantifying And Predicting Real-World Iatrogenic Severe Hypoglycemia In Adults With Type 1 Or 2 Diabetes Mellitus (The Inphorm Study, United States), Alexandria A. Ratzki-Leewing Sep 2022

Quantifying And Predicting Real-World Iatrogenic Severe Hypoglycemia In Adults With Type 1 Or 2 Diabetes Mellitus (The Inphorm Study, United States), Alexandria A. Ratzki-Leewing

Electronic Thesis and Dissertation Repository

Clinical outpatient strategies to accurately predict diabetes-related iatrogenic severe hypoglycemia (SH) are lacking. To redress this gap, we conducted the first-ever prognosis investigation of guideline-defined (Level 3) SH in the United States (US) (iNPHORM).

Chapter 4 details the design and implementation of iNPHORM: a prospective 12-wave panel survey (2020–2021). N=1206 adults with type 1 or insulin- and/or secretagogue-treated type 2 diabetes mellitus (T1DM or T2DM) were recruited from a US-wide, probability-based internet panel. For one-year, we collected monthly data on SH occurrence (frequencies, detection methods, symptoms, causes, and treatments) and related factors (anthropometric, sociodemographic, clinical, environmental/situational, behavioural, and psychosocial).

iNPHORM …


Developing Artificial Intelligence And Machine Learning To Support Primary Care Research And Practice, Jacqueline K. Kueper Jul 2022

Developing Artificial Intelligence And Machine Learning To Support Primary Care Research And Practice, Jacqueline K. Kueper

Electronic Thesis and Dissertation Repository

This thesis was motivated by the potential to use "everyday data", especially that collected in electronic health records (EHRs) as part of healthcare delivery, to improve primary care for clients facing complex clinical and/or social situations. Artificial intelligence (AI) techniques can identify patterns or make predictions with these data, producing information to learn about and inform care delivery. Our first objective was to understand and critique the body of literature on AI and primary care. This was achieved through a scoping review wherein we found the field was at an early stage of maturity, primarily focused on clinical decision support …


Spin And Distortion In Surgical Trials, Andrea Mataruga Apr 2022

Spin And Distortion In Surgical Trials, Andrea Mataruga

Electronic Thesis and Dissertation Repository

Research problem: Randomized controlled trials (RCTs) are essential; however, their validity can be threatened through distortion or spin. This study quantifies publication bias and distorted outcome reporting.

Methodology: All surgical RCTs registered on ClinicalTrials.gov from 1997-2017 were identified and a sample was obtained through random and intentional selection. Failure to publish (proportion of studies that remain unpublished), outcome distortion (changing intended outcomes), and spin (distorted presentation) were explored. Comparisons were made for positive versus negative studies and for high-income (HICs) versus low-middle income countries (LMICs).

Results: In total, 13,761 RCTs were registered (median enrollment size = 96, 94% from …


Fate Of Registered Studies From London, Ontario, Alex Bi Feb 2022

Fate Of Registered Studies From London, Ontario, Alex Bi

Electronic Thesis and Dissertation Repository

Introduction: Lack of study publication leads to bias in the scientific literature. It is important to better understand this phenomenon and find methods for mitigation.

Research Question: How many clinical trials registered on ClinicalTrials.gov in London, Ontario are started, completed, and published?

Methods: Data from all studies in the ClinicalTrials.gov registry associated with London, Ontario were collected, from registry conception until the end of 2017. We determined whether these registered studies were published by July 2020 and whether their first publication included their planned primary outcome at all. Main factors associated with non-publication were assessed using multivariable log-binomial regression. Multivariable …