Public Health Commons^™

An Open-Access, Interactive Decision-Support Tool To Facilitate Guideline-Driven Care For Hepatocellular Carcinoma, Robert J Wong, Channa Jayasekera, Patricia Jones, Fasiha Kanwal, Amit G Singal, Aijaz Ahmed, Robert Taglienti, Zobair Younossi, Laura Kulik, Neil Mehta

Faculty, Staff and Students Publications

Hepatocellular carcinoma (HCC) is increasing in incidence and is a leading cause of cancer-related mortality worldwide. Adherence to HCC surveillance guidelines and appropriate treatment triage of liver lesions may improve receipt of curative-intent treatment and improved survival. Late-stage HCC diagnosis reflects sub-optimal implementation of effective HCC surveillance, whereas inappropriate treatment triage or linkage to care accounts for the non-receipt of curative-intent in close to half of early-stage HCC in the USA. A free, open-access decision-support tool for liver lesions that incorporates current guideline recommendations in a user-friendly interface could improve appropriate and timely triage of patients to appropriate care. This …

Role Of Bacteriophage Therapy For Resistant Infections In Transplant Recipients, Paul Nicholls, Saima Aslam

Faculty, Staff and Students Publications

Purpose of review: Multidrug-resistant organisms (MDROs) are prevalent in transplant recipients and associated with poor outcomes. We review recent cases of phage therapy used to treat recalcitrant infections in transplant recipients and explore the future role of such therapy in this setting.

Recent findings: Individual case reports and small case series suggest possible efficacy of phage therapy for the treatment of MDRO infections in pre and posttransplant patients. Importantly, there have been no serious safety concerns in the reported cases that we reviewed. There are no applicable randomized controlled trials (RCTs) to better guide phage therapy at this time.

Summary: …

Association Between Cause Of Kidney Failure And Fracture Incidence In A National Us Dialysis Population Cohort Study, Susan Ziolkowski, Sai Liu, Maria E Montez-Rath, Michelle Denburg, Wolfgang C Winkelmayer, Glenn M Chertow, Michelle M O'Shaughnessy

Faculty, Staff and Students Publications

Background: Whether fracture rates, overall and by fracture site, vary by cause of kidney failure in patients receiving dialysis is unknown.

Methods: Using the US Renal Data System, we compared fracture rates across seven causes of kidney failure in patients who started dialysis between 1997 and 2014. We computed unadjusted and multivariable adjusted proportional sub-distribution hazard models, with fracture events (overall, and by site) as the outcome and immunoglobulin A nephropathy as the reference group. Kidney transplantation and death were competing events.

Results: Among 491 496 individuals, with a median follow-up of 2.0 (25%, 75% range 0.9-3.9) years, 62 954 …

Renal Osteodystrophy: A Historical Review Of Its Origins And Conceptual Evolution, Garabed Eknoyan, Sharon M Moe

Faculty, Staff and Students Publications

Long considered an inert supporting framework, bone studies went neglected until the 17th century when they began as descriptive microscopic studies of structure which over time progressed into that of chemistry and physiology. It was in the mid-19th century that studies evolved into an inquisitive discipline which matured into the experimental investigation of bone in health and disease in the 20th century, and ultimately that of molecular studies now deciphering the genetic language of bone biology. These fundamental studies were catalyzed by increasing clinical interest in bone disease. The first bone disease to be identified was rickets in 1645. Its …

A Narrative Review Of Sex And Gender Differences In Sleep Disordered Breathing: Gaps And Opportunities, Margaret Bublitz, Nour Adra, Leen Hijazi, Fidaa Shaib, Hrayr Attarian, Ghada Bourjeily

Faculty, Staff and Students Publications

Introduction: Sleep disordered breathing (SDB) is a common condition, associated with multiple comorbidities including cardiovascular and metabolic disease. It has been previously established that SDB is more prevalent in men than women, shifting the literature's focus away from the latter population. As such, underdiagnosis, and thus undertreatment, of SDB in women exists.

Methods: To establish the differences in prevalence, clinical presentation, and pathophysiology of SDB between the two sexes, a narrative review of the current literature was performed.

Results: Rates of SDB are higher among men, likely driven by differences in symptom presentation between men and women, with women presenting …

Loss Of Wnt4 In The Gubernaculum Causes Unilateral Cryptorchidism And Fertility Defects, Abhishek Seth, Juan C Bournat, Olga Medina-Martinez, Armando Rivera, Joshua Moore, Hunter Flores, Jill A Rosenfeld, Liya Hu, Carolina J Jorgez

Faculty, Staff and Students Publications

Undescended testis (UDT) affects 6% of male births. Despite surgical correction, some men with unilateral UDT may experience infertility with the contralateral descended testis (CDT) showing no A-dark spermatogonia. To improve our understanding of the etiology of infertility in UDT, we generated a novel murine model of left unilateral UDT. Gubernaculum-specific Wnt4 knockout (KO) mice (Wnt4-cKO) were generated using retinoic acid receptor β2-cre mice and were found to have a smaller left-unilateral UDT. Wnt4-cKO mice with abdominal UDT had an increase in serum follicle-stimulating hormone and luteinizing hormone and an absence of germ cells in the undescended testicle. Wnt4-cKO mice …

Cancer Evaluations During The Covid-19 Pandemic: An Observational Study Using National Veterans Affairs Data, Ashley N D Meyer, Hardeep Singh, Andrew J Zimolzak, Li Wei, Debra T Choi, Abigail D Marinez, Daniel R Murphy

Faculty, Staff and Students Publications

INTRODUCTION: Fewer cancer diagnoses have been made during the COVID-19 pandemic. Pandemic-related delays in cancer diagnosis could occur from limited access to care or patient evaluation delays (e.g., delayed testing after abnormal results). Follow-up of abnormal test results warranting evaluation for cancer was examined before and during the pandemic.

METHODS: Electronic trigger algorithms were applied to the Department of Veterans Affairs electronic health record data to assess follow-up of abnormal test results before (March 10, 2019-March 7, 2020) and during (March 8, 2020-March 6, 2021) the pandemic.

RESULTS: Electronic triggers were applied to 8,021,406 veterans' electronic health records to identify …

Chronic Kidney Disease, Risk Of Readmission, And Progression To End-Stage Renal Disease In 519,387 Patients Undergoing Coronary Artery Bypass Grafting, Ryan Nowrouzi, Christopher B Sylvester, John A Treffalls, Qianzi Zhang, Todd K Rosengart, Joseph S Coselli, Marc R Moon, Ravi K Ghanta, Subhasis Chatterjee

Faculty, Staff and Students Publications

Objective: The association between chronic kidney disease and adverse outcomes after coronary artery bypass grafting is well established; in contrast, the association between chronic kidney disease and readmission has been less thoroughly investigated. We hypothesized that patients at higher chronic kidney disease stages have greater risk of readmission, poorer operative outcomes, and greater hospitalization cost.

Methods: Using the 2016-2018 Nationwide Readmissions Database, we identified 519,387 patients who underwent isolated coronary artery bypass grafting. Patients were stratified by chronic kidney disease stage based on International Classification of Diseases 10th Revision classification. Multivariable logistic regression was used to assess risk factors for …

The Us Department Of Veterans Affairs Science And Health Initiative To Combat Infectious And Emerging Life-Threatening Diseases (Va Shield): A Biorepository Addressing National Health Threats, John B Harley, Saiju Pyarajan, Elizabeth S Partan, Lauren Epstein, Jason A Wertheim, Abhinav Diwan, Christopher W Woods, Victoria Davey, Sharlene Blair, Dennis H Clark, Kenneth M Kaufman, Shagufta Khan, Iouri Chepelev, Alexander Devine, Perry Cameron, Monica F Mccann, Mary Cloud B Ammons, Devin D Bolz, Jane K Battles, Jeffrey L Curtis, Mark Holodniy, Vincent C Marconi, Charles D Searles, David O Beenhouwer, Sheldon T Brown, Jonathan P Moorman, Zhi Q Yao, Maria C Rodriguez-Barradas, Shyam Mohapatra, Osmara Y Molina De Rodriguez, Emerson B Padiernos, Eric R Mcindoo, Emily Price, Hailey M Burgoyne, Ian Robey, Dawn C Schwenke, Carey L Shive, Ronald M Przygodzki, Rachel B Ramoni, Holly K Krull, Robert A Bonomo

Faculty, Staff and Students Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has demonstrated the need to share data and biospecimens broadly to optimize clinical outcomes for US military Veterans.

Methods: In response, the Veterans Health Administration established VA SHIELD (Science and Health Initiative to Combat Infectious and Emerging Life-threatening Diseases), a comprehensive biorepository of specimens and clinical data from affected Veterans to advance research and public health surveillance and to improve diagnostic and therapeutic capabilities.

Results: VA SHIELD now comprises 12 sites collecting de-identified biospecimens from US Veterans affected by SARS-CoV-2. In addition, 2 …

Targeting The Mtor Pathway For The Prevention Of Er-Negative Breast Cancer, Abhijit Mazumdar, William M Tahaney, Jamal L Hill, Yun Zhang, Sumankalai Ramachandran, Jitesh Kawedia, Jing Qian, Alejandro Contreras, Michelle I Savage, Lana A Vornik, Shizuko Sei, Altaf Mohammed, Powel H Brown

Faculty, Staff and Student Publications

Our results show that everolimus delays mammary tumor formation in multiple mouse models, suggesting that mTOR inhibitors will be useful for the prevention of ER-negative and triple-negative breast cancer in humans. See related Spotlight, p. 787.

Lack Of Consensus Among Healthcare Professionals At A Large Academic Medical Center On The Use Of Exome Sequencing For Prenatal Diagnosis, Kylie Johnson, Hadi Erfani, Mohamad Ali Maktabi, Ignatia Van Den Veyver, Salma Nassef

Center for Medical Ethics and Health Policy Staff Publications

Prenatal exome sequencing (ES) is increasingly used for prenatal diagnosis because emerging data indicate it has incremental diagnostic benefit in pregnancies with fetal anomalies without identified genetic abnormalities by karyotyping and chromosomal microarray analysis. The aim of this study was to evaluate the medical community's attitude toward the clinical utility and use of exome sequencing for prenatal diagnosis and to address differences in attitudes and responses by type of practitioner, level of training, and years passed since last full-time training. We analyzed the answers of 109 trainees and professionals in the fields of genetic counseling, laboratory science, and medicine to …

Fulminant Lung Fibrosis In Non-Resolvable Covid-19 Requiring Transplantation, Soma S K Jyothula, Andrew Peters, Yafen Liang, Weizhen Bi, Pooja Shivshankar, Simon Yau, Puneet S Garcha, Xiaoyi Yuan, Bindu Akkanti, Scott Collum, Nancy Wareing, Rajarajan A Thandavarayan, Fernando Poli De Frias, Ivan O Rosas, Bihong Zhao, L Maximilian Buja, Holger K Eltzschig, Howard J Huang, Harry Karmouty-Quintana

Faculty, Staff and Student Publications

BACKGROUND: Coronavirus Disease 2019 (COVID-19) can lead to the development of acute respiratory distress syndrome (ARDS). In some patients with non-resolvable (NR) COVID-19, lung injury can progress rapidly to the point that lung transplantation is the only viable option for survival. This fatal progression of lung injury involves a rapid fibroproliferative response and takes on average 15 weeks from initial symptom presentation. Little is known about the mechanisms that lead to this fulminant lung fibrosis (FLF) in NR-COVID-19.

METHODS: Using a pre-designed unbiased PCR array for fibrotic markers, we analyzed the fibrotic signature in a subset of NR-COVID-19 lungs. We …

Stellate Ganglion Block For Long Covid Symptom Management: A Case Report, Mashfee H Khan, Kennedy P Kirkpatrick, Yi Deng, Krishna B Shah

Faculty, Staff and Students Publications

Stellate ganglion block (SGB) is gaining increasing acceptance as a treatment modality for various medical conditions. It works by blocking neuronal transmissions which in turn alleviates sympathetically-driven disease processes. Many of the prolonged sequelae of long COVID are thought to be mediated by dysregulation of the autonomic nervous system, and SGB is being investigated as a potential option for symptomatic management of long COVID. This case report demonstrates the efficacy of SGB in a previously healthy patient for the management of long COVID symptoms including fatigue, post-exertional malaise, shortness of breath, and gastrointestinal symptoms.

Payment Profiles: Using Payment Transaction Data To Identify And Characterize Gamblers, Kasra Ghaharian

UNLV Theses, Dissertations, Professional Papers, and Capstones

Payment providers in the gambling industry facilitate transactions, allowing customers to transfer money to and from wagering accounts. Payments transaction data is information that is captured from these transactions, including, for example, the type, amount, time, and location. How this data may be used for gambling harm minimization and prevention has garnered significant interest, particularly due to accelerated payments modernization in the wake of the COVID-19 pandemic. With this study, I explored the utility of payments transaction data to categorize subgroups of gamblers in order to identify individuals who may be at-risk of harm. I benchmarked six cluster analysis methods …

Automated Approach For The Enhancement Of Scaffolding Structure Monitoring With Strain Sensor Data, Sayan Sakhakarmi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Construction researchers have made a significant effort to improve the safety of scaffolding structures, as a large proportion of workers are involved in construction activities requiring scaffolds. However, most past studies focused on design and planning aspects of scaffolds. While limited studies investigated scaffolding safety during construction, they are limited to simple cases only with limited failure modes and simple scaffolds. In response to this limitation, this study aims to develop an automated scaffold monitoring approach capable of monitoring large scaffolds. Accordingly, this study developed an automated scaffold safety monitoring framework that leverages sensor data collected from a scaffold, scaffold …

Covid-19 Vaccine Acceptance Behavior Among Hispanics/Latinxs In Nevada: A Theory-Based Analysis, Tara Marie Naoe Tacderan Wong Nerida

UNLV Theses, Dissertations, Professional Papers, and Capstones

The COVID-19 pandemic has impacted many lives around the world, leaving negative repercussions including health effects, economic downturns, and social and physical restrictions. The pandemic has also revealed many disproportionate health impacts on vulnerable populations, especially among the Hispanic and Latinx populations. The use of the three COVID-19 vaccines in the United States has presented a form of protection against additional negative impacts. However, hesitancy toward the COVID-19 vaccine has hindered its rapid uptake, preventing the country from reaching herd immunity and ultimately ending the pandemic. Current research is minimal in understanding the intentions of receiving the COVID-19 vaccine among …

2022-11-30_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2022-11-30_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …

Medication Adherence And Self-Management Practices Among Type 2 Diabetes Mellitus Patients In Jeli District, Kelantan, Malaysia, Marzuki Bin Muhammad, Farzana Yasmin, Alabed Ali A. Alabed, Bibi Florina Abdullah, Sandeep Poddar

Kesmas

This study was carried out to investigate the level of medication adherence and diabetic knowledge among type 2 diabetes mellitus patients in Jeli District, Kelantan, Malaysia. This cross-sectional study was done from February to July 2019 by giving a questionnaire to 150 type 2 diabetes mellitus patients aged 40-80 years at three primary health cares in Jeli District, Kelantan, Malaysia. The quantitative descriptive method was used in this study. The findings of this study revealed that knowledge was significantly related to poor adherence. When sex, history of diabetes, and education were accounted for, patients with low diabetic knowledge had an …

Factors Influencing Handwriting Development Among Preschool Children: A Systematic Review, Zati Izny Achymy, Masne Kadar, Nor Afifi Razaob, Farahiyah Wan Yunus

Kesmas

Handwriting development is essential for academic performance, yet the research on the factors contributing to it is scant. This systematic review aimed to provide a comprehensive overview of the factors contributing to handwriting development among preschool children that may benefit public health knowledge, especially among teachers, parents, and therapists. A systematic search was conducted using four databases: PubMed, ERIC, CINAHL, and Google Scholar. During the preliminary search, 565 relevant studies were found. Screening, review selection, and characterization were performed based on the inclusion and exclusion criteria. The inclusion criteria included preschool children, quantitative, written in English, and published in January …

Breastfeeding Duration More Than 18 Months Possibly Lowers The Risk Of Language Development Delay In Children Aged 18–35 Months, Andi Faradilah, Andi Musafir Rusyaidi, Syatirah Jalaluddin, Ary I. Savitri

Kesmas

Studies have demonstrated the benefits of breastfeeding (BF) on children’s cognitive function and language development. However, most cognitive and language tools used in these studies have limited ability to identify children’s language development delays. The Language Development Survey (LDS) is expected to provide detailed information on children’s language development. This study aimed to examine the association between BF duration and children’s LDS. A questionnaire was administered to 286 BF mothers to obtain information on their BF duration, and LDS was employed to assess children’s language development. Language delays were detected in 91 (31.8%) children (LDS-vocabulary) and 35.7% children (LDS-phrase). This …

Factors Associated With Depression Among Type 2 Diabetes Mellitus Patients At A Tertiary Hospital During The Covid-19 Pandemic, Muhammad Ikhsan Mokoagow, Dian Pitawati, Ditya Nona Arisandy, Nadya Magfira, Pratiwi Indah Palupi, Jerry Nasarudin, Marina Epriliawati, Ida Ayu Kshanti

Kesmas

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia that can cause various complications, economic burdens, and psychosocial issues that eventually lead to depression. This study aimed to describe the prevalence of depression among type 2 diabetes mellitus patients in the Internal Medicine Outpatient Clinic of a South Jakarta tertiary hospital during the COVID-19 pandemic. This cross-sectional study was conducted from May to July 2021. The data were collected consecutively from 100 patients aged 18 years or older who came for regular consultation. The instrument used for determining depression is Beck Depression Inventory-II. The prevalence of depression, a correlation …

Quality Of Life Of Hypertensive Patients Undergoing Chronic Disease Management Program During The Covid-19 Pandemic, Widya Astuty Lolo, Gayatri Citraningtyas, Deby Afriani Mpila, Heri Wijaya, Sandeep Poddar

Kesmas

The COVID-19 pandemic has restricted some common activities for hypertensive patients undergoing the Chronic Disease Management Program/Program Pengelolaan Penyakit Kronis in primary health care, decreasing the quality of life. This study aimed to measure the quality of life of hypertensive patients undergoing the Chronic Disease Management Program at primary health care of Manado City, North Sulawesi Province, Indonesia, during the COVID-19 pandemic and determine the factors influencing hypertension such as sex, age, education, employment status, monthly income and duration of hypertension. This cross-sectional study was carried out on 150 hypertensive patients randomly sampled at primary health care from June to …

So2 Concentration And The Occurrence Of Acute Respiratory Infection In Children Under Five, Puji Amrih Lestari, Budi Haryanto

Kesmas

Jakarta is the capital city of Indonesia, with 10.7 million inhabitants with poor air quality as of 2020. Higher levels of pollution often come with an increase in the number of health risks and pneumonia cases. This study aimed to determine the association between SO2 concentration and the occurrence of acute respiratory infection (ARI) in children under five. An ecological time series design was implemented during the study by utilizing secondary data of SO2 concentrations and ARI from the Indonesian Agency for Meteorological, Climatological, and Geophysics, the Special Capital Region of Jakarta Environmental, and Health Office. Statistical correlation tests were …

Knowledge, Attitudes, And Practices (Kap) Towards Covid-19 Pandemic Among Pregnant Women In A Tertiary Hospital In Karachi, Pakistan, Sumaira Naz, Syeda Dur E Shawar, Shamila Saleem, Ayesha Malik, Amir Raza

Department of Obstetrics & Gynaecology

Background: The aim of this study was to evaluate the knowledge, attitude, and practices (KAP) of the pregnant population during the COVID-19 pandemic in a tertiary care hospital.
Methods: This cross-sectional study was conducted at Aga Khan University Hospital, Karachi, Pakistan. KAP towards COVID-19 was assessed using 21-item questionnaires. A score for each category was calculated and points were summed. The outcome variables of KAP were compared with demographic characteristics. Data were analyzed by using SPSS 19.
Results: A total of 377 patients participated in the study. The majority of the patients were multiparous (36.8%) in the age group of …

Impact Of Instrumental Support From Family On Medication Adherence Among Tuberculosis Patients, Astuti Yuni Nursasi, Mega Hasanul Huda, Syifa Widya Rahmasari

Kesmas

Instrumental support is concrete and tangible, for instance, helping to provide food or accompanying patients to health care facilities. However, its impact on medication adherence among tuberculosis patients in Indonesia needs to be explored. This study aimed to examine the impact of instrumental support from family on tuberculosis patients’ adherence to medication in Bogor City, West Java Province, Indonesia. A cross-sectional study involving 106 participants with an age average of 39.7 (SD = 14.9) was conducted in 12 primary health care (PHC). The independent variables (age, sex, education, employment status, wealth index, and the distance between home and PHC) of …

Cognitive Function In Type 2 Diabetes Mellitus Patients Taking Metformin And Metformin-Sulfonylurea, Abu Rachman, Rani Sauriasari, Nadia Farhanah Syafhan, Pukovisa Prawiroharjo, Hindun Wilda Risni

Kesmas

The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This cross-sectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for > 6 months and aged > 36 years. Cognitive function was assessed using the …

Association Of Provider Hpv Vaccination Training With Provider Assessment Of Hpv Vaccination Status And Recommendation Of Hpv Vaccination, Ikponmwosa Osaghae, Charles Darkoh, Onyema Greg Chido-Amajuoyi, Wenyaw Chan, Paige Padgett Wermuth, Mala Pande, Sonia A Cunningham, Sanjay Shete

Faculty, Staff and Student Publications

The delivery of strong HPV vaccine recommendations hinges on the expertise of healthcare providers (HCPs) in assessing patients' status and recommending HPV vaccination. We conducted a population-based cross-sectional study of HCPs practicing in Texas to examine the relationship between HPV vaccination training of HCPs and HPV vaccination status assessment and recommendation. Logistic regression analyses were used to assess the association between HCPs' formal training and recency of training in HPV vaccination promotion or counseling with HPV vaccination status assessment and recommendation. Of the 1,283 HCPs who completed the online survey, 43% had received training in HPV vaccination promotion or counseling, …

Avpcancerfree: Impact Of A Digital Behavior Change Intervention On Parental Hpv Vaccine –Related Perceptions And Behaviors, Ross Shegog, Lara S Savas, C Mary Healy, Erica L Frost, Sharon P Coan, Efrat K Gabay, Sharice M Preston, Stanley W Spinner, Mathew Wilbur, Elisabeth Becker, Travis Teague, Sally W Vernon

Faculty, Staff and Student Publications

Parent hesitancy contributes to reduced HPV vaccination rates. The HPVcancerfree app (HPVCF) was designed to assist parents in making evidence-based decisions regarding HPV vaccination. This study examined if parents of vaccine-eligible youth (11-12 yrs.) who use HPVCF in addition to usual care demonstrate significantly more positive intentions and attitudes toward HPV vaccination and greater HPV vaccination rates compared to those not using HPVCF. Clinics (n = 51) within a large urban pediatric network were randomly assigned to treatment (HPVCF + usual care) or comparison (usual care only) conditions in a RCT conducted between September 2017 and February 2019. Parents completed …

An Ai-Driven Clinical Care Pathway To Reduce 30-Day Readmission For Chronic Obstructive Pulmonary Disease (Copd) Patients, Lin Wang, Guihua Li, Chika F Ezeana, Richard Ogunti, Mamta Puppala, Tiancheng He, Xiaohui Yu, Solomon S Y Wong, Zheng Yin, Aaron W Roberts, Aryan Nezamabadi, Pingyi Xu, Adaani Frost, Robert E Jackson, Stephen T C Wong

Faculty, Staff and Student Publications

Healthcare regulatory agencies have mandated a reduction in 30-day hospital readmission rates and have targeted COPD as a major contributor to 30-day readmissions. We aimed to develop and validate a simple tool deploying an artificial neural network (ANN) for early identification of COPD patients with high readmission risk. Using COPD patient data from eight hospitals within a large urban hospital system, four variables were identified, weighted and validated. These included the number of in-patient admissions in the previous 6 months, the number of medications administered on the first day, insurance status, and the Rothman Index on hospital day one. An …