3,483 results match your criteria PLoS Medicine [Journal]


The association between heatwaves and risk of hospitalization in Brazil: A nationwide time series study between 2000 and 2015.

PLoS Med 2019 Feb 22;16(2):e1002753. Epub 2019 Feb 22.

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Background: To our knowledge, no study has assessed the association between heatwaves and risk of hospitalization and how it may change over time in Brazil. We quantified the heatwave-hospitalization association in Brazil during 2000-2015.

Methods And Findings: Daily data on hospitalization and temperature were collected from 1,814 cities (>78% of the national population) in the hottest five consecutive months during 2000-2015. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002753DOI Listing
February 2019

COSMOS-E: Guidance on conducting systematic reviews and meta-analyses of observational studies of etiology.

PLoS Med 2019 Feb 21;16(2):e1002742. Epub 2019 Feb 21.

Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Background: To our knowledge, no publication providing overarching guidance on the conduct of systematic reviews of observational studies of etiology exists.

Methods And Findings: Conducting Systematic Reviews and Meta-Analyses of Observational Studies of Etiology (COSMOS-E) provides guidance on all steps in systematic reviews of observational studies of etiology, from shaping the research question, defining exposure and outcomes, to assessing the risk of bias and statistical analysis. The writing group included researchers experienced in meta-analyses and observational studies of etiology. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002742DOI Listing
February 2019

National policies and care provision in pregnancy and childbirth for twins in Eastern and Southern Africa: A mixed-methods multi-country study.

PLoS Med 2019 Feb 19;16(2):e1002749. Epub 2019 Feb 19.

Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Background: High-risk pregnancies, such as twin pregnancies, deserve particular attention as mortality is very high in this group. With a view to inform policy and national guidelines development for the Sustainable Development Goals, we reviewed national training materials, guidelines, and policies underpinning the provision of care in relation to twin pregnancies and assessed care provided to twins in 8 Eastern and Southern African countries: Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

Methods And Findings: We located policies and guidelines by reviewing national repositories and by contacting experts to systematically map country-level maternal and newborn training materials, guidelines, and policies. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002749DOI Listing
February 2019

The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: A cluster randomised trial.

PLoS Med 2019 Feb 15;16(2):e1002745. Epub 2019 Feb 15.

Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Background: The emergence and spread of multidrug-resistant Plasmodium falciparum in the Greater Mekong Subregion (GMS) threatens global malaria elimination efforts. Mass drug administration (MDA), the presumptive antimalarial treatment of an entire population to clear the subclinical parasite reservoir, is a strategy to accelerate malaria elimination. We report a cluster randomised trial to assess the effectiveness of dihydroartemisinin-piperaquine (DP) MDA in reducing falciparum malaria incidence and prevalence in 16 remote village populations in Myanmar, Vietnam, Cambodia, and the Lao People's Democratic Republic, where artemisinin resistance is prevalent. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002745DOI Listing
February 2019
1 Read

Community-, facility-, and individual-level outcomes of a district mental healthcare plan in a low-resource setting in Nepal: A population-based evaluation.

PLoS Med 2019 Feb 14;16(2):e1002748. Epub 2019 Feb 14.

Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Background: In low-income countries, care for people with mental, neurological, and substance use (MNS) disorders is largely absent, especially in rural settings. To increase treatment coverage, integration of mental health services into community and primary healthcare settings is recommended. While this strategy is being rolled out globally, rigorous evaluation of outcomes at each stage of the service delivery pathway from detection to treatment initiation to individual outcomes of care has been missing. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002748DOI Listing
February 2019

Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis.

PLoS Med 2019 Feb 11;16(2):e1002744. Epub 2019 Feb 11.

The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.

Background: Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002744
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http://dx.doi.org/10.1371/journal.pmed.1002744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370184PMC
February 2019
4 Reads

Long-term outcomes of an educational intervention to reduce antibiotic prescribing for childhood upper respiratory tract infections in rural China: Follow-up of a cluster-randomised controlled trial.

PLoS Med 2019 Feb 5;16(2):e1002733. Epub 2019 Feb 5.

School of Health Care Management, Shandong University, Jinan, China.

Background: Inappropriate antibiotic prescribing causes widespread serious health problems. To reduce prescribing of antibiotics in Chinese primary care to children with upper respiratory tract infections (URTIs), we developed an intervention comprising clinical guidelines, monthly prescribing review meetings, doctor-patient communication skills training, and education materials for caregivers. We previously evaluated our intervention using an unblinded cluster-randomised controlled trial (cRCT) in 25 primary care facilities across two rural counties. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363140PMC
February 2019
2 Reads

The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial.

PLoS Med 2019 Feb 5;16(2):e1002736. Epub 2019 Feb 5.

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Background: Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.

Methods And Findings: A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363143PMC
February 2019

Trazodone use and risk of dementia: A population-based cohort study.

PLoS Med 2019 Feb 5;16(2):e1002728. Epub 2019 Feb 5.

Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom.

Background: In vitro and animal studies have suggested that trazodone, a licensed antidepressant, may protect against dementia. However, no studies have been conducted to assess the effect of trazodone on dementia in humans. This electronic health records study assessed the association between trazodone use and the risk of developing dementia in clinical practice. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002728DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363148PMC
February 2019
1 Read

Lifetime risk and multimorbidity of non-communicable diseases and disease-free life expectancy in the general population: A population-based cohort study.

PLoS Med 2019 Feb 4;16(2):e1002741. Epub 2019 Feb 4.

Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.

Background: Non-communicable diseases (NCDs) are leading causes of premature disability and death worldwide. However, the lifetime risk of developing any NCD is unknown, as are the effects of shared common risk factors on this risk.

Methods And Findings: Between July 6, 1989, and January 1, 2012, we followed participants from the prospective Rotterdam Study aged 45 years and older who were free from NCDs at baseline for incident stroke, heart disease, diabetes, chronic respiratory disease, cancer, and neurodegenerative disease. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361416PMC
February 2019
1 Read

Setting targets for HIV/AIDS-What lessons can be learned from other disease control programmes?

PLoS Med 2019 Feb 4;16(2):e1002735. Epub 2019 Feb 4.

Public Health England, London, United Kingdom.

In a Collection Review, Richard Hayes and colleagues discuss metrics for assessing progress in control of the HIV/AIDS epidemic in the context of prior disease control programmes. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002735DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361469PMC
February 2019

Evidence of a causal relationship between body mass index and psoriasis: A mendelian randomization study.

PLoS Med 2019 Jan 31;16(1):e1002739. Epub 2019 Jan 31.

Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.

Background: Psoriasis is a common inflammatory skin disease that has been reported to be associated with obesity. We aimed to investigate a possible causal relationship between body mass index (BMI) and psoriasis.

Methods And Findings: Following a review of published epidemiological evidence of the association between obesity and psoriasis, mendelian randomization (MR) was used to test for a causal relationship with BMI. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002739DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354959PMC
January 2019
2 Reads

Human trafficking and labor exploitation: Toward identifying, implementing, and evaluating effective responses.

PLoS Med 2019 Jan 29;16(1):e1002740. Epub 2019 Jan 29.

Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom.

In an Editorial, Ligia Kiss and Cathy Zimmerman discuss the need for research on the prevention of human trafficking and mitigation of its effects. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002740
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http://dx.doi.org/10.1371/journal.pmed.1002740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350954PMC
January 2019
2 Reads

Hospital admission on weekends for patients who have surgery and 30-day mortality in Ontario, Canada: A matched cohort study.

PLoS Med 2019 Jan 29;16(1):e1002731. Epub 2019 Jan 29.

Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.

Background: Healthcare interventions on weekends have been associated with increased mortality and adverse clinical outcomes, but these findings are inconsistent. We hypothesized that patients admitted to hospital on weekends who have surgery have an increased risk of death compared with patients who are admitted and have surgery on weekdays.

Methods And Findings: This matched cohort study included 318,202 adult patients from Ontario health administrative and demographic databases, admitted to acute care hospitals from 1 January 2005 to 31 December 2015. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002731DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350956PMC
January 2019

Who elects the weekend?

PLoS Med 2019 Jan 29;16(1):e1002732. Epub 2019 Jan 29.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Chaim M. Bell and Lauren Lapointe-Shaw discuss the meaning of the "weekend effect" in outcomes for hospital admissions and surgeries, and comment on surprising new results published in PLOS Medicine this week. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002732DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350955PMC
January 2019

Association between temperature variability and daily hospital admissions for cause-specific cardiovascular disease in urban China: A national time-series study.

PLoS Med 2019 Jan 28;16(1):e1002738. Epub 2019 Jan 28.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

Background: Epidemiological studies have provided compelling evidence of associations between ambient temperature and cardiovascular disease. However, evidence of effects of daily temperature variability on cardiovascular disease is scarce and mixed. We aimed to examine short-term associations between temperature variability and hospital admissions for cause-specific cardiovascular disease in urban China. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002738DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349307PMC
January 2019
1 Read

The role of price and convenience in use of oral rehydration salts to treat child diarrhea: A cluster randomized trial in Uganda.

PLoS Med 2019 Jan 24;16(1):e1002734. Epub 2019 Jan 24.

Haas School of Business, University of California at Berkeley, Berkeley, California, United States of America.

Background: Over half a million children die each year of diarrheal illness, although nearly all deaths could be prevented with oral rehydration salts (ORS). The literature on ORS documents both impressive health benefits and persistent underuse. At the same time, little is known about why ORS is underused and what can be done to increase use. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002734
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http://dx.doi.org/10.1371/journal.pmed.1002734DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345441PMC
January 2019
3 Reads

Predicting survival from colorectal cancer histology slides using deep learning: A retrospective multicenter study.

PLoS Med 2019 Jan 24;16(1):e1002730. Epub 2019 Jan 24.

Department of Medical Oncology and Internal Medicine VI, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

Background: For virtually every patient with colorectal cancer (CRC), hematoxylin-eosin (HE)-stained tissue slides are available. These images contain quantitative information, which is not routinely used to objectively extract prognostic biomarkers. In the present study, we investigated whether deep convolutional neural networks (CNNs) can extract prognosticators directly from these widely available images. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002730DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345440PMC
January 2019
1 Read

Evaluating strategies for control of tuberculosis in prisons and prevention of spillover into communities: An observational and modeling study from Brazil.

PLoS Med 2019 Jan 24;16(1):e1002737. Epub 2019 Jan 24.

Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America.

Background: It has been hypothesized that prisons serve as amplifiers of general tuberculosis (TB) epidemics, but there is a paucity of data on this phenomenon and the potential population-level effects of prison-focused interventions. This study (1) quantifies the TB risk for prisoners as they traverse incarceration and release, (2) mathematically models the impact of prison-based interventions on TB burden in the general population, and (3) generalizes this model to a wide range of epidemiological contexts.

Methods And Findings: We obtained individual-level incarceration data for all inmates (n = 42,925) and all reported TB cases (n = 5,643) in the Brazilian state of Mato Grosso do Sul from 2007 through 2013. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345418PMC
January 2019
1 Read

Prior dengue virus infection and risk of Zika: A pediatric cohort in Nicaragua.

PLoS Med 2019 Jan 22;16(1):e1002726. Epub 2019 Jan 22.

Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America.

Background: Zika virus (ZIKV) emerged in northeast Brazil in 2015 and spread rapidly across the Americas, in populations that have been largely exposed to dengue virus (DENV). The impact of prior DENV infection on ZIKV infection outcome remains unclear. To study this potential impact, we analyzed the large 2016 Zika epidemic in Managua, Nicaragua, in a pediatric cohort with well-characterized DENV infection histories. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002726
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http://dx.doi.org/10.1371/journal.pmed.1002726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342296PMC
January 2019
5 Reads

Progress in the HIV epidemic: Identifying goals and measuring success.

PLoS Med 2019 Jan 18;16(1):e1002729. Epub 2019 Jan 18.

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.

Substantial progress has been made towards the goal of ending the HIV/AIDS epidemic due to advancements in both prevention and treatment of HIV. However, major challenges still remain. We describe basic principles of epidemic control in the context of HIV and identify a number of attainable goals in terms of control and elimination of HIV in specific populations and risk groups, given currently available HIV prevention and treatment methods. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002729DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338352PMC
January 2019
1 Read

No causal effects of serum urate levels on the risk of chronic kidney disease: A Mendelian randomization study.

PLoS Med 2019 Jan 15;16(1):e1002725. Epub 2019 Jan 15.

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.

Background: Studies have shown strong positive associations between serum urate (SU) levels and chronic kidney disease (CKD) risk; however, whether the relation is causal remains uncertain. We evaluate whether genetic data are consistent with a causal impact of SU level on the risk of CKD and estimated glomerular filtration rate (eGFR).

Methods And Findings: We used Mendelian randomization (MR) methods to evaluate the presence of a causal effect. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002725
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http://dx.doi.org/10.1371/journal.pmed.1002725DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333326PMC
January 2019
11 Reads

Rapid antiretroviral therapy initiation in low- and middle-income countries: A resource-based approach.

PLoS Med 2019 Jan 15;16(1):e1002723. Epub 2019 Jan 15.

Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

In an Essay, Mark Tenforde and colleagues advocate continued provision of baseline CD4 cell count testing in HIV care in low- and middle-income countries. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333330PMC
January 2019
1 Read

Association between severe drought and HIV prevention and care behaviors in Lesotho: A population-based survey 2016-2017.

PLoS Med 2019 Jan 14;16(1):e1002727. Epub 2019 Jan 14.

Centers for Disease Control and Prevention, Maseru, Lesotho.

Background: A previous analysis of the impact of drought in Africa on HIV demonstrated an 11% greater prevalence in HIV-endemic rural areas attributable to local rainfall shocks. The Lesotho Population-Based HIV Impact Assessment (LePHIA) was conducted after the severe drought of 2014-2016, allowing for reevaluation of this relationship in a setting of expanded antiretroviral coverage.

Methods And Findings: LePHIA selected a nationally representative sample between November 2016 and May 2017. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002727DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331084PMC
January 2019
3 Reads

Airway obstruction and bronchial reactivity from age 1 month until 13 years in children with asthma: A prospective birth cohort study.

PLoS Med 2019 Jan 8;16(1):e1002722. Epub 2019 Jan 8.

Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

Background: Studies have shown that airway obstruction and increased bronchial reactivity are present in early life in children developing asthma, which challenges the dogma that airway inflammation leads to low lung function. Further studies are needed to explore whether low lung function and bronchial hyperreactivity are inherent traits increasing the risk of developing airway inflammation and asthmatic symptoms in order to establish timely primary preventive initiatives.

Methods And Findings: We investigated 367 (89%) of the 411 children from the at-risk Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC2000) birth cohort born to mothers with asthma, who were assessed by spirometry and bronchial reactivity to methacholine from age 1 month, plethysmography and bronchial reversibility from age 3 years, cold dry air hyperventilation from age 4 years, and exercise challenge at age 7 years. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002722
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http://dx.doi.org/10.1371/journal.pmed.1002722DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324782PMC
January 2019
7 Reads

Health system costs for individual and comorbid noncommunicable diseases: An analysis of publicly funded health events from New Zealand.

PLoS Med 2019 Jan 8;16(1):e1002716. Epub 2019 Jan 8.

Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

Background: There is little systematic assessment of how total health expenditure is distributed across diseases and comorbidities. The objective of this study was to use statistical methods to disaggregate all publicly funded health expenditure by disease and comorbidities in order to answer three research questions: (1) What is health expenditure by disease phase for noncommunicable diseases (NCDs) in New Zealand? (2) Is the cost of having two NCDs more or less than that expected given the independent costs of each NCD? (3) How is total health spending disaggregated by NCDs across age and by sex?

Methods And Findings: We used linked data for all adult New Zealanders for publicly funded events, including hospitalisation, outpatient, pharmaceutical, laboratory testing, and primary care from 1 July 2007 to 30 June 2014. These data include 18. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324792PMC
January 2019
2 Reads

The influence of obesity-related factors in the etiology of renal cell carcinoma-A mendelian randomization study.

Authors:
Mattias Johansson Robert Carreras-Torres Ghislaine Scelo Mark P Purdue Daniela Mariosa David C Muller Nicolas J Timpson Philip C Haycock Kevin M Brown Zhaoming Wang Yuanqing Ye Jonathan N Hofmann Matthieu Foll Valerie Gaborieau Mitchell J Machiela Leandro M Colli Peng Li Jean-Guillaume Garnier Helene Blanche Anne Boland Laurie Burdette Egor Prokhortchouk Konstantin G Skryabin Meredith Yeager Sanja Radojevic-Skodric Simona Ognjanovic Lenka Foretova Ivana Holcatova Vladimir Janout Dana Mates Anush Mukeriya Stefan Rascu David Zaridze Vladimir Bencko Cezary Cybulski Eleonora Fabianova Viorel Jinga Jolanta Lissowska Jan Lubinski Marie Navratilova Peter Rudnai Simone Benhamou Geraldine Cancel-Tassin Olivier Cussenot Elisabete Weiderpass Börje Ljungberg Raviprakash Tumkur Sitaram Christel Häggström Fiona Bruinsma Susan J Jordan Gianluca Severi Ingrid Winship Kristian Hveem Lars J Vatten Tony Fletcher Susanna C Larsson Alicja Wolk Rosamonde E Banks Peter J Selby Douglas F Easton Gabriella Andreotti Laura E Beane Freeman Stella Koutros Satu Männistö Stephanie Weinstein Peter E Clark Todd L Edwards Loren Lipworth Susan M Gapstur Victoria L Stevens Hallie Carol Matthew L Freedman Mark M Pomerantz Eunyoung Cho Kathryn M Wilson J Michael Gaziano Howard D Sesso Neal D Freedman Alexander S Parker Jeanette E Eckel-Passow Wen-Yi Huang Richard J Kahnoski Brian R Lane Sabrina L Noyes David Petillo Bin Tean Teh Ulrike Peters Emily White Garnet L Anderson Lisa Johnson Juhua Luo Julie Buring I-Min Lee Wong-Ho Chow Lee E Moore Timothy Eisen Marc Henrion James Larkin Poulami Barman Bradley C Leibovich Toni K Choueiri G Mark Lathrop Jean-Francois Deleuze Marc Gunter James D McKay Xifeng Wu Richard S Houlston Stephen J Chanock Caroline Relton J Brent Richards Richard M Martin George Davey Smith Paul Brennan

PLoS Med 2019 Jan 3;16(1):e1002724. Epub 2019 Jan 3.

International Agency for Research on Cancer (IARC), Lyon, France.

Background: Several obesity-related factors have been associated with renal cell carcinoma (RCC), but it is unclear which individual factors directly influence risk. We addressed this question using genetic markers as proxies for putative risk factors and evaluated their relation to RCC risk in a mendelian randomization (MR) framework. This methodology limits bias due to confounding and is not affected by reverse causation. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002724DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317776PMC
January 2019
11 Reads

HIV self-testing alone or with additional interventions, including financial incentives, and linkage to care or prevention among male partners of antenatal care clinic attendees in Malawi: An adaptive multi-arm, multi-stage cluster randomised trial.

PLoS Med 2019 Jan 2;16(1):e1002719. Epub 2019 Jan 2.

Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Background: Conventional HIV testing services have been less comprehensive in reaching men than in reaching women globally, but HIV self-testing (HIVST) appears to be an acceptable alternative. Measurement of linkage to post-test services following HIVST remains the biggest challenge, yet is the biggest driver of cost-effectiveness. We investigated the impact of HIVST alone or with additional interventions on the uptake of testing and linkage to care or prevention among male partners of antenatal care clinic attendees in a novel adaptive trial. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314606PMC
January 2019
2 Reads

A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study.

PLoS Med 2018 Dec 31;15(12):e1002718. Epub 2018 Dec 31.

Department of Pathology, Yale School of Medicine, New Haven, Connecticut, United States of America.

Background: A person's rate of aging has important implications for his/her risk of death and disease; thus, quantifying aging using observable characteristics has important applications for clinical, basic, and observational research. Based on routine clinical chemistry biomarkers, we previously developed a novel aging measure, Phenotypic Age, representing the expected age within the population that corresponds to a person's estimated mortality risk. The aim of this study was to assess its applicability for differentiating risk for a variety of health outcomes within diverse subpopulations that include healthy and unhealthy groups, distinct age groups, and persons with various race/ethnic, socioeconomic, and health behavior characteristics. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312200PMC
December 2018
1 Read

Better medicine through machine learning: What's real, and what's artificial?

PLoS Med 2018 Dec 31;15(12):e1002721. Epub 2018 Dec 31.

Usher Institute of Population Health and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.

Machine Learning Special Issue Guest Editors Suchi Saria, Atul Butte, and Aziz Sheikh cut through the hyperbole with an accessible and accurate portrayal of the forefront of machine learning in clinical translation. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312199PMC
December 2018
1 Read

Comparative efficacy and acceptability of psychosocial interventions for individuals with cocaine and amphetamine addiction: A systematic review and network meta-analysis.

PLoS Med 2018 Dec 26;15(12):e1002715. Epub 2018 Dec 26.

Department of Psychiatry, University of Oxford, Oxford, United Kingdom.

Background: Clinical guidelines recommend psychosocial interventions for cocaine and/or amphetamine addiction as first-line treatment, but it is still unclear which intervention, if any, should be offered first. We aimed to estimate the comparative effectiveness of all available psychosocial interventions (alone or in combination) for the short- and long-term treatment of people with cocaine and/or amphetamine addiction.

Methods And Findings: We searched published and unpublished randomised controlled trials (RCTs) comparing any structured psychosocial intervention against an active control or treatment as usual (TAU) for the treatment of cocaine and/or amphetamine addiction in adults. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002715DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306153PMC
December 2018
3 Reads

Defining rights-based indicators for HIV epidemic transition.

PLoS Med 2018 Dec 21;15(12):e1002720. Epub 2018 Dec 21.

Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

In a Policy Forum, Joseph Amon and colleagues discuss human rights indicators for tracking progress toward ending the HIV epidemic. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002720DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303010PMC
December 2018
1 Read

Effectiveness of a text-messaging-based smoking cessation intervention ("Happy Quit") for smoking cessation in China: A randomized controlled trial.

PLoS Med 2018 Dec 18;15(12):e1002713. Epub 2018 Dec 18.

Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.

Background: China has the highest global prevalence of cigarette smokers, accounting for more than 40% of the total cigarette consumption in the world. Considering the shortage of smoking cessation services in China, and the acceptability, feasibility, and efficacy of mobile-phone-based text messaging interventions for quitting smoking in other countries, we conducted a mobile-phone-based smoking cessation study in China.

Methods And Findings: We conducted a randomized controlled trial in China across 30 cities and provinces from August 17, 2016, to May 27, 2017. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002713
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http://dx.doi.org/10.1371/journal.pmed.1002713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298640PMC
December 2018
24 Reads

Supermarket policies on less-healthy food at checkouts: Natural experimental evaluation using interrupted time series analyses of purchases.

PLoS Med 2018 Dec 18;15(12):e1002712. Epub 2018 Dec 18.

Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.

Background: In response to public concerns and campaigns, some United Kingdom supermarkets have implemented policies to reduce less-healthy food at checkouts. We explored the effects of these policies on purchases of less-healthy foods commonly displayed at checkouts.

Methods And Findings: We used a natural experimental design and two data sources providing complementary and unique information. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002712DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298641PMC
December 2018
1 Read

Small for gestational age and risk of childhood mortality: A Swedish population study.

PLoS Med 2018 Dec 18;15(12):e1002717. Epub 2018 Dec 18.

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Background: Small for gestational age (SGA) has been associated with increased risks of stillbirth and neonatal mortality, but data on long-term childhood mortality are scarce. Maternal antenatal care, including globally reducing the risk of SGA birth, may be key to achieving the Millennium Development Goal of reducing under-5 mortality. We therefore aimed to examine the association between SGA and mortality from 28 days to <18 years using a population-based and a sibling control design. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298647PMC
December 2018
2 Reads

Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials.

PLoS Med 2018 Dec 18;15(12):e1002714. Epub 2018 Dec 18.

Department of Psychiatry, VU University Medical Centre, Amsterdam, the Netherlands.

Background: Face-to-face brief interventions for problem drinking are effective, but they have found limited implementation in routine care and the community. Internet-based interventions could overcome this treatment gap. We investigated effectiveness and moderators of treatment outcomes in internet-based interventions for adult problem drinking (iAIs). Read More

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http://dx.plos.org/10.1371/journal.pmed.1002714
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http://dx.doi.org/10.1371/journal.pmed.1002714DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298657PMC
December 2018
7 Reads

Associations between sex work laws and sex workers' health: A systematic review and meta-analysis of quantitative and qualitative studies.

PLoS Med 2018 Dec 11;15(12):e1002680. Epub 2018 Dec 11.

University of Toronto, Toronto, Ontario, Canada.

Background: Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers' safety, health, and access to services, and the pathways through which these effects occur.

Methods And Findings: We searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289426PMC
December 2018
1 Read

Raltegravir-intensified initial antiretroviral therapy in advanced HIV disease in Africa: A randomised controlled trial.

PLoS Med 2018 Dec 4;15(12):e1002706. Epub 2018 Dec 4.

Medical Research Council Clinical Trials Unit at University College London, University College London, London, United Kingdom.

Background: In sub-Saharan Africa, individuals infected with HIV who are severely immunocompromised have high mortality (about 10%) shortly after starting antiretroviral therapy (ART). This group also has the greatest risk of morbidity and mortality associated with immune reconstitution inflammatory syndrome (IRIS), a paradoxical response to successful ART. Integrase inhibitors lead to significantly more rapid declines in HIV viral load (VL) than all other ART classes. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002706
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http://dx.doi.org/10.1371/journal.pmed.1002706DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279020PMC
December 2018
18 Reads

Metabolic syndrome in pregnancy and risk for adverse pregnancy outcomes: A prospective cohort of nulliparous women.

PLoS Med 2018 Dec 4;15(12):e1002710. Epub 2018 Dec 4.

Robinson Research Institute, University of Adelaide, Adelaide, Australia.

Background: Obesity increases the risk for developing gestational diabetes mellitus (GDM) and preeclampsia (PE), which both associate with increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in women in later life. In the general population, metabolic syndrome (MetS) associates with T2DM and CVD. The impact of maternal MetS on pregnancy outcomes, in nulliparous pregnant women, has not been investigated. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002710DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279018PMC
December 2018
5 Reads

Deep learning for lung cancer prognostication: A retrospective multi-cohort radiomics study.

PLoS Med 2018 Nov 30;15(11):e1002711. Epub 2018 Nov 30.

Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.

Background: Non-small-cell lung cancer (NSCLC) patients often demonstrate varying clinical courses and outcomes, even within the same tumor stage. This study explores deep learning applications in medical imaging allowing for the automated quantification of radiographic characteristics and potentially improving patient stratification.

Methods And Findings: We performed an integrative analysis on 7 independent datasets across 5 institutions totaling 1,194 NSCLC patients (age median = 68. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002711
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http://dx.doi.org/10.1371/journal.pmed.1002711DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6269088PMC
November 2018
13 Reads

Characterising risk of in-hospital mortality following cardiac arrest using machine learning: A retrospective international registry study.

PLoS Med 2018 Nov 30;15(11):e1002709. Epub 2018 Nov 30.

Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia.

Background: Resuscitated cardiac arrest is associated with high mortality; however, the ability to estimate risk of adverse outcomes using existing illness severity scores is limited. Using in-hospital data available within the first 24 hours of admission, we aimed to develop more accurate models of risk prediction using both logistic regression (LR) and machine learning (ML) techniques, with a combination of demographic, physiologic, and biochemical information.

Methods And Findings: Patient-level data were extracted from the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database for patients who had experienced a cardiac arrest within 24 hours prior to admission to an intensive care unit (ICU) during the period January 2006 to December 2016. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267953PMC
November 2018
2 Reads

Deep learning and artificial intelligence in radiology: Current applications and future directions.

PLoS Med 2018 Nov 30;15(11):e1002707. Epub 2018 Nov 30.

Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

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http://dx.doi.org/10.1371/journal.pmed.1002707DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267951PMC
November 2018
1 Read

Advancing the beneficial use of machine learning in health care and medicine: Toward a community understanding.

Authors:
Linda Nevin

PLoS Med 2018 Nov 30;15(11):e1002708. Epub 2018 Nov 30.

Public Library of Science, San Francisco, California, United States of America and Cambridge, United Kingdom.

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http://dx.plos.org/10.1371/journal.pmed.1002708
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http://dx.doi.org/10.1371/journal.pmed.1002708DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267950PMC
November 2018
2 Reads

Relationships between intensity, duration, cumulative dose, and timing of smoking with age at menopause: A pooled analysis of individual data from 17 observational studies.

PLoS Med 2018 Nov 27;15(11):e1002704. Epub 2018 Nov 27.

The University of Queensland, School of Public Health, Brisbane, Queensland, Australia.

Background: Cigarette smoking is associated with earlier menopause, but the impact of being a former smoker and any dose-response relationships on the degree of smoking and age at menopause have been less clear. If the toxic impact of cigarette smoking on ovarian function is irreversible, we hypothesized that even former smokers might experience earlier menopause, and variations in intensity, duration, cumulative dose, and age at start/quit of smoking might have varying impacts on the risk of experiencing earlier menopause.

Methods And Findings: A total of 207,231 and 27,580 postmenopausal women were included in the cross-sectional and prospective analyses, respectively. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002704DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258514PMC
November 2018
5 Reads

Enhancing the prediction of acute kidney injury risk after percutaneous coronary intervention using machine learning techniques: A retrospective cohort study.

PLoS Med 2018 Nov 27;15(11):e1002703. Epub 2018 Nov 27.

Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America.

Background: The current acute kidney injury (AKI) risk prediction model for patients undergoing percutaneous coronary intervention (PCI) from the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) employed regression techniques. This study aimed to evaluate whether models using machine learning techniques could significantly improve AKI risk prediction after PCI.

Methods And Findings: We used the same cohort and candidate variables used to develop the current NCDR CathPCI Registry AKI model, including 947,091 patients who underwent PCI procedures between June 1, 2009, and June 30, 2011. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258473PMC
November 2018
10 Reads

Mobile detection of autism through machine learning on home video: A development and prospective validation study.

PLoS Med 2018 Nov 27;15(11):e1002705. Epub 2018 Nov 27.

Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America.

Background: The standard approaches to diagnosing autism spectrum disorder (ASD) evaluate between 20 and 100 behaviors and take several hours to complete. This has in part contributed to long wait times for a diagnosis and subsequent delays in access to therapy. We hypothesize that the use of machine learning analysis on home video can speed the diagnosis without compromising accuracy. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258501PMC
November 2018
2 Reads

Deep-learning-assisted diagnosis for knee magnetic resonance imaging: Development and retrospective validation of MRNet.

PLoS Med 2018 Nov 27;15(11):e1002699. Epub 2018 Nov 27.

Department of Radiology, Stanford University, Stanford, California, United States of America.

Background: Magnetic resonance imaging (MRI) of the knee is the preferred method for diagnosing knee injuries. However, interpretation of knee MRI is time-intensive and subject to diagnostic error and variability. An automated system for interpreting knee MRI could prioritize high-risk patients and assist clinicians in making diagnoses. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002699
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http://dx.doi.org/10.1371/journal.pmed.1002699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258509PMC
November 2018
23 Reads

Machine learning in population health: Opportunities and threats.

PLoS Med 2018 Nov 27;15(11):e1002702. Epub 2018 Nov 27.

Health Metrics Sciences, University of Washington, Seattle, Washington, United States of America.

Abraham D. Flaxman and Theo Vos of the Institute for Health Metrics and Evaluation, University of Washington, discuss near-term applications for ML in population health and name their priorities for ongoing ML development. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258474PMC
November 2018
1 Read

Development and validation of machine learning models to identify high-risk surgical patients using automatically curated electronic health record data (Pythia): A retrospective, single-site study.

PLoS Med 2018 Nov 27;15(11):e1002701. Epub 2018 Nov 27.

Duke Institute for Health Innovation, Durham, North Carolina, United States of America.

Background: Pythia is an automated, clinically curated surgical data pipeline and repository housing all surgical patient electronic health record (EHR) data from a large, quaternary, multisite health institute for data science initiatives. In an effort to better identify high-risk surgical patients from complex data, a machine learning project trained on Pythia was built to predict postoperative complication risk.

Methods And Findings: A curated data repository of surgical outcomes was created using automated SQL and R code that extracted and processed patient clinical and surgical data across 37 million clinical encounters from the EHRs. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002701
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http://dx.doi.org/10.1371/journal.pmed.1002701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258507PMC
November 2018
11 Reads