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At least 955 records · Page 53Linked to original sources
PubMed1993

Medically related motor vehicle injury costs by body region and severity.

For motor vehicle crashes, we estimated the medically related costs of nonfatal injury by body region and severity. Our primary data sources were paid charges reported in the Detailed Claims Information data base of the National Council on Compensation Insurance and injury incidence and severity reported in the National Highway Traffic Safety Administration's National Accident Sampling System (NASS). Brain and lower extremity injuries account for the largest portion of medical costs. Spinal cord and severe brain injuries cost more per case. Our average costs per case are very close to those in a report to Congress but come from completely different data sources. Thus, national data bases are providing consistent medical cost estimates.

Abdominal Injuries↗
PubMed2003

Men's use of sexual health services.

CONTEXT AND OBJECTIVE: Previous research on users of sexual health services has focused primarily on women. However, a focus on men also is needed to address sexual ill-health. This paper uses various data sources to describe the level of, and trends in, men's use of sexual health services in England. DATA SOURCES: Routine data are presented on clients of family planning clinics (FPCs), Brook Advisory Centres and attendances at genitourinary medicine (GUM) clinics. Cross-sectional surveys used include the National Survey of Sexual Attitudes and Lifestyles, Morbidity Statistics from General Practice and the National Gay Men's Sex Survey. RESULTS: The number of male clients attending FPCs has increased by 160% over the 1990s. Most of this increase is due to more men obtaining condoms. The ages of these clients are unknown, but data from Brook Advisory Centres show an increase among younger men. The one service for which male and female use is approximately equal is GUM. Male cases of sexually transmitted infections and other treatments have increased over the 1990s, although not at the same rate as female cases. Use of GUM clinics by homosexually active men is much greater than by all men. Recent data on men's use of general practice for sexual health are lacking. DISCUSSION AND CONCLUSIONS: While overall service use among men is still at a comparatively low level, it has increased over the 1990s for some services. Further in-depth research should question men's wants and demands from sexual health services.

Attitude to Health↗
PubMedDate not supplied

The accuracy of medical records and police reports in determining motor vehicle crash characteristics.

OBJECTIVE: To determine the accuracy of police, emergency department, and ambulance records in describing motor vehicle crash (MVC) characteristics when compared with a crash investigation report (CIR). METHODS: This study was a retrospective record review. Sixty-three motor vehicle crash (MVC) patients transported to a university hospital emergency department via ambulance and also reported in a crash investigation record (CIR) during the period January 1993 to December 1995 comprised the study population. The crash characteristics analyzed were occupant position (OP), restraint use (RU), air bag deployment (AD), type of impact (TI), ejection (EJ), and external cause-of-injury code (EC). The accuracies of the police report (PR), the emergency department record (EDR), and the ambulance report (AR) for each patient were compared with the CIR by computing percent agreement, with 95% confidence intervals (95% CIs) for each variable and for each data source. RESULTS: Overall average agreement was 92.9% for PR, 89.7% for EDR, and 80.7% for AR. The overall average agreement for each variable was 98.9% for EJ, 92.1% for AD, 91.5% for OP, 90.5% for EC, 77.2% for RU, and 76.2% for TI. For all but one variable (RU), 95% CIs overlapped between data sources. CONCLUSIONS: The accuracy of data sources used to determine crash characteristics varies. Using a CIR as the standard, the PR was the most accurate. Inaccuracies occurred most frequently for RU and TI. Researchers and clinicians need to be aware of these inaccuracies.

Accidents, Traffic↗
PubMed2005

Health utilities in Alzheimer's disease and implications for cost-effectiveness analysis.

The National Institute for Health and Clinical Excellence (NICE) provisional decision against memantine and other medications for Alzheimer's disease (AD) has generated much discussion. In its decision, NICE expressed concern about the data source used for the utility scores in the industry submission of the memantine model. NICE therefore turned to an alternative data source. However, in doing so, it made the key assumption that moderate-to-severe AD patients living in the community were independent. Furthermore, the NICE data source also had its limitations. There are numerous limitations in inferring from available data how utilities vary between dependent and non-dependent patients with AD. Most importantly, we lack direct evidence from primary data. Nonetheless, it seems reasonable to assume that patients with severe AD, and likely those with moderate AD as well, have full-time care needs, regardless of their setting. The NICE assumption that they do not results in a difference in utilities between dependent and non-dependent AD individuals of only 0.06. This seems to be at the low end of what one would consider a reasonable estimate.

Alzheimer Disease↗
PubMed2006

Levels of analysis for the study of environmental health disparities.

Reducing racial/ethnic and socioeconomic environmental health disparities requires a comprehensive multilevel conceptual and quantitative approach that recognizes the various levels through which environmental health disparities are produced and perpetuated. We propose a conceptual framework that incorporates the micro level, contained within the local level, which in turn is contained within the macro level. We discuss the utility of multilevel techniques to examine environmental level (both physical and social) and individual-level factors to appropriately quantify and improve our understanding of environmental health disparities. We discuss the reasoning and the methodological approach behind multilevel modeling, including differentiating between individual and contextual influences on individual outcomes. Next we address the questions and principles that guide the choice of levels or geographic units in multilevel studies. Finally, we address the ways in which different data sources can be combined to produce suitable data for multilevel analyses. We provide some examples of how such data sources can be linked to create multilevel data structures, and offer suggestions to facilitate the integration of multilevel techniques in environmental health disparities research and monitoring.

Environmental Exposure↗
PubMed2003

Validity and interpretation of mortality, health service and survey data on COPD and asthma in England.

The comparability of asthma and chronic obstructive pulmonary disease (COPD) epidemiology in different English routine data sources was examined to explore their use and validity in investigating environmental influences on respiratory health. National data were obtained for mortality, emergency hospital admissions, general practitioner contacts and symptoms in the early 1990s. Age/sex patterns, seasonal variations and regional and urban/rural age/sex standardised event ratios were examined. Spearman rank correlations were used to describe consistency of regional rankings across data sets. Asthma showed inconsistent disease patterns in different data sources and weak correlations for regional rankings but COPD was notably consistent. Unmeasured confounders may partly explain the findings, but individual level adjustment for social class and smoking (possible for symptoms) only partially attenuated the higher COPD rates in northern and urban areas and did not affect findings for asthma. When epidemiological patterns are consistent across data sources as with chronic obstructive pulmonary disease in England, healthcare use is likely to reflect the underlying prevalence and severity of disease and can be used to study environmental influences. When patterns vary, as with asthma, the validity of the data in relation to its intended use must be carefully considered.

Adolescent↗
PubMedDate not supplied

[Health status and gender in Catalonia. An approach using the information sources available].

OBJECTIVE: To present health status differences between men and women in Catalonia across the main available data sources. METHODS: The main institutional health data sources of the Catalan population are presented. Mortality and morbidity differences by gender are studied. RESULTS: Men die before than women and present more frequently pathologies that require hospitalary care. Unhealthy behaviours are more frequent in men than in women. Women in general, in all social classes, present more frequently chronic disorders and disabilities and declare worse perception of health status than men of the same social class. CONCLUSIONS: Institutional sources of data available in Catalonia allow the description of gender differences in health, nevertheless new variables should be included to improve gender perspective analyse.

Adolescent↗
PubMed1990

Integrity of small data bases in computer analysis of dietary data.

The integrity of data bases to support microcomputer-based dietary analysis programs has become increasingly important to developers and users of nutritional analysis software. This paper reviews critical issues in maintaining data integrity during development of small nutritional data bases. Because a limited number of large, source data bases provides the data for smaller, special-purpose data bases, this review initially focuses on factors that affect the quality and precision of methodologies used in establishing large data bases. Issues discussed are accuracy of source data as determined by analytical methodology and imputation procedures, and methods for insuring representativeness of data. The effect of data transfer procedures on small data base integrity are discussed, including use of multiple sources and standardization of naming and coding conventions. Also reviewed are procedures for selecting reduced numbers of foods and nutrients without sacrificing accuracy of analysis, and methods currently in use for validating small data bases.

Databases, Factual↗
PubMed2005

5-azacytidine and decitabine monotherapies of myelodysplastic disorders.

OBJECTIVE: To review and differentiate the pharmacology, toxicology, pharmacokinetics, and results of major clinical trials of 5-azacytidine (5-AzaC) and 5-aza-2'-deoxycytidine (decitabine) therapy of myelodysplastic disorders. DATA SOURCES: A PubMed/MEDLINE search was conducted (1966-October 2004) using the following terms: DNA methylation, myelodysplastic disorders, 5-azacytidine, and 5-aza-2'-deoxycytidine (decitabine). Additional data sources included bibliographies from identified articles and manufacturer information. STUDY SELECTION AND DATA EXTRACTION: Clinical trials for the treatment of various malignancies by hypomethylating agents were selected from data sources. All published, major clinical trials evaluating 5-AzaC or decitabine in myelodysplastic disorders and transformed myeloid leukemia treatment were included. DATA SYNTHESIS: Myelodysplastic disorders are a group of bone marrow stem cell hyperplasias and dysplasias that result in ineffective hematopoiesis. Myelodysplastic disorders and transformed leukemia have poor prognosis and minimal response to chemotherapy. DNA hypomethylating agents have been shown to improve overall response rates (increased neutrophil, leukocyte, and platelet counts), time to leukemic progression, and quality of life compared with supportive therapy. The incidence of the most common adverse effects (nausea, vomiting, myelosuppression) can be reduced by low-dose, continuous, or extended-interval infusion. CONCLUSIONS: Since appropriate dosing schedules of decitabine are being investigated, comparison of the clinical effectiveness of 5-AzaC and decitabine would be premature at this time. DNA hypomethylating agents show promise as monotherapies of myelodysplastic disorders and transformed leukemia and may be useful as a component of combination chemotherapy of various malignancies.

Antimetabolites, Antineoplastic↗
PubMed2004

QIS: A framework for biomedical database federation.

Query Integrator System (QIS) is a database mediator framework intended to address robust data integration from continuously changing heterogeneous data sources in the biosciences. Currently in the advanced prototype stage, it is being used on a production basis to integrate data from neuroscience databases developed for the SenseLab project at Yale University with external neuroscience and genomics databases. The QIS framework uses standard technologies and is intended to be deployable by administrators with a moderate level of technological expertise: It comes with various tools, such as interfaces for the design of distributed queries. The QIS architecture is based on a set of distributed network-based servers, data source servers, integration servers, and ontology servers, that exchange metadata as well as mappings of both metadata and data elements to elements in an ontology. Metadata version difference determination coupled with decomposition of stored queries is used as the basis for partial query recovery when the schema of data sources alters.

Computer Communication Networks↗
PubMed2001

Firearm-related fatality surveillance in Hartford County, Connecticut.

OBJECTIVES: To evaluate the feasibility of implementing a firearm fatality surveillance system in Hartford County, Connecticut. METHODS: Medical examiner, police, and crime lab data were collected for firearm deaths occurring in Hartford County during 1997. Data included characteristics of victims, suspects, and firearms. We used standard criteria for evaluating an epidemiological surveillance system. RESULTS: The surveillance system detected 52 firearm-related fatalities; 31 were suicides and 21 were homicides. Handguns accounted for 50% of the suicides and 72% of the homicides. Sensitivity was 96%, specificity was 100%, representativeness adequate, simplicity enhanced by a common case identifier, flexibility constrained by the use of existing data, timeliness varied by data source, and system acceptable to all data sources. Estimated statewide cost is $200 per case, or $52,000 per year. CONCLUSION: Firearm injury surveillance in Hartford County is feasible and expansion to statewide coverage possible. The surveillance yielded considerable data at reasonable costs.

Connecticut↗
PubMed2003

Variations in hospitalization rates among nursing home residents: the role of discretionary hospitalizations.

OBJECTIVE: To examine variations in hospitalization rates among nursing home residents associated with discretionary hospitalization practices. DATA SOURCES: Quarterly Medicaid case-mix reimbursement data from the state of Massachusetts served as the core data source for this study, which was linked with data from the Medicare Provider Analysis and Review file (MEDPAR) to specify hospitalization status, nursing facility attribute data from the state of Massachusetts to specify facility-level organizational and structural attributes, and data from the Area Resource File (ARF) to specify area market-level attributes. Data spans three years (1991-1993) to produce a longitudinal analytical file containing 72,319 person-quarter-level observations. STUDY DESIGN: Two-step, multivariate logistic regression models were estimated for highly discretionary hospitalizations versus those containing less discretion, and low discretionary hospitalizations versus those containing greater amounts of physician discretion. PRINCIPAL FINDINGS: Findings indicate that facility case-mix levels and area hospital bed supply levels contribute to variations in hospitalization rates among nursing home residents. Highly discretionary hospitalizations appear to be most sensitive to patient diagnoses best described as chronic, ambulatory care sensitive conditions. CONCLUSIONS: Findings suggest that defining hospitalizations simply in terms of whether an event occurs versus otherwise may obscure valuable information regarding the contribution of various risk factors to highly discretionary versus low discretionary hospitalization rates.

Aged↗
PubMed2005

Fast protein classification with multiple networks.

MOTIVATION: Support vector machines (SVMs) have been successfully used to classify proteins into functional categories. Recently, to integrate multiple data sources, a semidefinite programming (SDP) based SVM method was introduced. In SDP/SVM, multiple kernel matrices corresponding to each of data sources are combined with weights obtained by solving an SDP. However, when trying to apply SDP/SVM to large problems, the computational cost can become prohibitive, since both converting the data to a kernel matrix for the SVM and solving the SDP are time and memory demanding. Another application-specific drawback arises when some of the data sources are protein networks. A common method of converting the network to a kernel matrix is the diffusion kernel method, which has time complexity of O(n(3)), and produces a dense matrix of size n x n. RESULTS: We propose an efficient method of protein classification using multiple protein networks. Available protein networks, such as a physical interaction network or a metabolic network, can be directly incorporated. Vectorial data can also be incorporated after conversion into a network by means of neighbor point connection. Similar to the SDP/SVM method, the combination weights are obtained by convex optimization. Due to the sparsity of network edges, the computation time is nearly linear in the number of edges of the combined network. Additionally, the combination weights provide information useful for discarding noisy or irrelevant networks. Experiments on function prediction of 3588 yeast proteins show promising results: the computation time is enormously reduced, while the accuracy is still comparable to the SDP/SVM method. AVAILABILITY: Software and data will be available on request.

Algorithms↗
PubMed2004

Bevacizumab: an angiogenesis inhibitor with efficacy in colorectal and other malignancies.

OBJECTIVE: To review the pharmacology, pharmacokinetics, and pivotal clinical trials for bevacizumab, emphasizing its use in colorectal cancer. DATA SOURCES: A PubMed/MEDLINE search was conducted (1966-April 2004) using the following terms: bevacizumab, Avastin, anti-VEGF, anti-angiogenesis, and colorectal cancer. Additional data sources included meeting abstracts, bibliographies from identified articles, and information from the manufacturer. STUDY SELECTION AND DATA EXTRACTION: Preclinical and clinical trials that used bevacizumab for the treatment of colorectal cancer and other malignancies were selected from the data sources. All published, randomized clinical trials evaluating bevacizumab in colorectal cancer were included in this review. DATA SYNTHESIS: Despite advances in chemotherapy, current therapeutic options for metastatic disease provide only temporary benefit for most patients. Bevacizumab is the first anti-cancer agent shown to provide benefit for patients with cancer by inhibiting angiogenesis. Bevacizumab has shown significant activity in the treatment of many cancers, including metastatic colorectal cancer. When used in combination with fluorouracil-based chemotherapy, bevacizumab improves overall response rates, time to progression, and survival in patients with metastatic colorectal cancer. Common toxicities associated with bevacizumab include hypertension, bleeding episodes, and thrombotic events. CONCLUSIONS: Although clinical knowledge on the effectiveness of bevacizumab is limited, early data indicate that it is a promising agent, with a novel mechanism of action, for patients with metastatic cancer, including colorectal cancer.

Angiogenesis Inhibitors↗
PubMed2003

Multi-class protein fold classification using a new ensemble machine learning approach.

Protein structure classification represents an important process in understanding the associations between sequence and structure as well as possible functional and evolutionary relationships. Recent structural genomics initiatives and other high-throughput experiments have populated the biological databases at a rapid pace. The amount of structural data has made traditional methods such as manual inspection of the protein structure become impossible. Machine learning has been widely applied to bioinformatics and has gained a lot of success in this research area. This work proposes a novel ensemble machine learning method that improves the coverage of the classifiers under the multi-class imbalanced sample sets by integrating knowledge induced from different base classifiers, and we illustrate this idea in classifying multi-class SCOP protein fold data. We have compared our approach with PART and show that our method improves the sensitivity of the classifier in protein fold classification. Furthermore, we have extended this method to learning over multiple data types, preserving the independence of their corresponding data sources, and show that our new approach performs at least as well as the traditional technique over a single joined data source. These experimental results are encouraging, and can be applied to other bioinformatics problems similarly characterised by multi-class imbalanced data sets held in multiple data sources.

Amino Acid Sequence↗
PubMed2003

Public health surveillance of diabetes in the United States.

The Centers for Disease Control and Prevention Division of Diabetes Translation supports a national and state surveillance system that analyzes, interprets, and reports on diabetes risk behaviors, risk factors, care practices, morbidity, and mortality. Data sources include surveys, the U.S. Renal Data System, the Indian Health Service, information on hospital inpatients, birth and death certificates, and special studies to use and to better understand the usefulness of data from managed care, Medicare, and Medicaid for monitoring diabetes. These data are used to define the magnitude and burden of diabetes; monitor changes in burden over time; guide public health planning and policy making, and assess progress toward diabetes objectives, such as those in Healthy People 2010. Challenges facing the diabetes surveillance system are limitations in data sources; the capture of undiagnosed diabetes; tracking key risk factors, such as levels of glycemia and lipids; and surveillance of high- or emerging-risk populations such as racial and ethnic groups, children and youth, and those with prediabetes. Limited resources, competing priorities, and issues of data privacy also challenge surveillance. To overcome these factors, the Division of Diabetes Translation strongly emphasizes partnering with other organizations, such as the Medicare and Medicaid programs, managed care, and other chronic disease programs.

Centers for Disease Control and Prevention, U.S.↗
PubMed1999

Use of claims data for research on treatment and outcomes of depression care.

BACKGROUND: Data sources such as medical insurance claims are increasingly used in outcomes research. In this report, we present opportunities and limitations associated with the use of such data for outcomes research in the area of depression. OBJECTIVES: The purpose of this report is to illustrate the use of administrative claims data in conducting research in the area of depression. Information in this report is intended to be helpful to both experienced health services researchers and to those who may be new to the field of either outcomes research or mental health research. FORMAT: This report covers measurement of outcomes, possible data sources, episode construction, and statistical methodologies that are appropriate when conducting depression research using claims data. Through examples and references, issues to be considered in each of these areas are examined and recommendations are made. Strengths and limitations of claims data will also be pointed out. CONCLUSIONS: The use of claims data to conduct outcomes research in depression should be carried out responsibly. Limitations with using claims data to identify patients with depression must be acknowledged and appropriate methodologies should be used. Still, these data sources provide a rich opportunity to conduct outcomes research in depression, and much can be learned using administrative claims data.

Depressive Disorder↗