| 1. |
- Almodares, Qays, et al.
(författare)
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Larger right atrium than left atrium is associated with all-cause mortality in elderly patients with heart failure
- 2017
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Ingår i: Echocardiography - a Journal of Cardiovascular Ultrasound and Allied Techniques. - : Wiley. - 0742-2822. ; 34:5, s. 662-667
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWhile left atrial (LA) enlargement is known as an early sign of left heart disease with prognostic implications in heart failure (HF), the importance of right atrial (RA) enlargement is less well studied, and the prognostic implications of interatrial size comparison are insufficiently understood. The aim of this study was to test the hypothesis that RA area larger than LA area in apical four-chamber view is associated with all-cause mortality in elderly patients with HF independent of left ventricular ejection fraction (LVEF). MethodsRetrospectively, 289 patients above 65years hospitalized for HF between April 2007 and April 2008, and who underwent an echocardiogram, were enrolled. All-cause mortality was registered during a follow-up of at least 56months. Baseline parameters measured were RA area, LA area, LA volume, LVEF, left ventricular mass (LVM), tissue Doppler systolic velocity of right ventricular free wall (SmRV), presence of severe tricuspid regurgitation (TR), tricuspid gradient, central venous pressure, systolic pulmonary artery pressure, as well as some parameters of diastolic function. ResultsIn univariate analysis RA larger than LA was associated with all-cause mortality (hazard ratio [HR] of 1.88, P<.001). The relation of RA larger than LA to all-cause mortality remained even after adjusting for age, heart rate, LVEF, atrial fibrillation, percutaneous coronary intervention, LVM index, LA volume index, SmRV, and the presence of severe TR (HR: 1.79, P=.04). ConclusionRA larger than LA, independently of LVEF, is associated with all-cause mortality in elderly patients hospitalized due to HF.
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| 4. |
- Carlsson, Mats, 1965-, et al.
(författare)
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Terminology support for development of sharable knowledge modules
- 1996
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Ingår i: Informatics for Health and Social Care. - : Informa UK Limited. - 1753-8157 .- 1753-8165. ; 21:3, s. 207-214
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Tidskriftsartikel (refereegranskat)abstract
- Lack of an agreed infrastructure for terminology is identified as one of the major barriers to interchange of knowledge modules and integration of knowledge bases with other clinical information systems. The goal of the GALEN project is to bridge this gap between different terminology systems through the construction of a terminology server, which is based on a rich conceptual model with mapping facilities to natural language expressions and coding schemas. The long term goal is to support communication between medical information systems. Arden Syntax is a standard format for the creation of knowledge modules, with sharability as one of the main objectives. Since Arden Syntax is based on a data-driven approach, the data items used need to be adapted to locally available terminology. The GALEN approach appears to be complementary to Arden Syntax and to the development of sharable knowledge modules. The major theme of this paper is utilization of the GALEN terminology server for knowledge module authoring. Two systems are presented, a knowledge base manager and a client to the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology services is discussed.
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| 5. |
- Gandaglia, Giorgio, et al.
(författare)
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Clinical Characterization of Patients Diagnosed with Prostate Cancer and Undergoing Conservative Management : A PIONEER Analysis Based on Big Data
- 2023
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Ingår i: European Urology. - 0302-2838.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Conservative management is an option for prostate cancer (PCa) patients either with the objective of delaying or even avoiding curative therapy, or to wait until palliative treatment is needed. PIONEER, funded by the European Commission Innovative Medicines Initiative, aims at improving PCa care across Europe through the application of big data analytics. Objective: To describe the clinical characteristics and long-term outcomes of PCa patients on conservative management by using an international large network of real-world data. Design, setting, and participants: From an initial cohort of >100 000 000 adult individuals included in eight databases evaluated during a virtual study-a-thon hosted by PIONEER, we identified newly diagnosed PCa cases (n = 527 311). Among those, we selected patients who did not receive curative or palliative treatment within 6 mo from diagnosis (n = 123 146). Outcome measurements and statistical analysis: Patient and disease characteristics were reported. The number of patients who experienced the main study outcomes was quantified for each stratum and the overall cohort. Kaplan-Meier analyses were used to estimate the distribution of time to event data. Results and limitations: The most common comorbidities were hypertension (35–73%), obesity (9.2–54%), and type 2 diabetes (11–28%). The rate of PCa-related symptomatic progression ranged between 2.6% and 6.2%. Hospitalization (12–25%) and emergency department visits (10–14%) were common events during the 1st year of follow-up. The probability of being free from both palliative and curative treatments decreased during follow-up. Limitations include a lack of information on patients and disease characteristics and on treatment intent. Conclusions: Our results allow us to better understand the current landscape of patients with PCa managed with conservative treatment. PIONEER offers a unique opportunity to characterize the baseline features and outcomes of PCa patients managed conservatively using real-world data. Patient summary: Up to 25% of men with prostate cancer (PCa) managed conservatively experienced hospitalization and emergency department visits within the 1st year after diagnosis; 6% experienced PCa-related symptoms. The probability of receiving therapies for PCa decreased according to time elapsed after the diagnosis.
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| 6. |
- Hjelmgren, Ola, et al.
(författare)
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Does retinopathy predict stroke recurrence in type 2 diabetes patients: A retrospective study?
- 2019
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Aims To study if retinopathy increases the risk of stroke recurrence in stroke patients with type 2 diabetes. Also, to study if stroke patients with type 2 diabetes have an increased risk of stroke recurrence compared to non-diabetics and if stroke patients with type 2 diabetes, regardless of retinopathy, have a higher incidence of carotid stenosis. Also, to study if stroke patients with type 2 diabetes retinopathy have increased incidence of carotid stenosis. We included 445 patients with type 2 diabetes mellitus and a matched control group of 445 patients without diabetes, who had all suffered their first stroke or TIA. Information on retinopathy, risk factors and stroke recurrence were obtained from registers and medical records. Retinopathy did not increase the risk of stroke recurrence in diabetes patients, HR 0.89 (0.51-1.53), p = 0.67. The risk of stroke recurrence was not increased in diabetics compared to non-diabetes. Diabetes patients had an increased prevalence of carotid stenosis compared to non-diabetics, 1.69 (1.15-2.48), p = 0.008. The prevalence of carotid stenosis in diabetics with retinopathy was not increased compared to diabetics without retinopathy. Retinopathy is not a predictor of stroke recurrence or carotid stenosis in type 2 diabetes patients.
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| 8. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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Anonymisation of Swedish Clinical Data
- 2007
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Ingår i: Lecture Notes in Computer Science. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 0302-9743. ; 4594, s. 237-241
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Tidskriftsartikel (refereegranskat)abstract
- There is a constantly growing demand for exchanging clinical and health-related information electronically. In the era of the Electronic Health Record the release of individual data for research, health care statistics, monitoring of new diagnostic tests and tracking disease outbreak alerts are some of the areas in which the protection of (patient) privacy has become an important concern. In this paper we present a system for automatic anonymisation of Swedish clinical free text, in the form of discharge letters, by applying generic named entity recognition technology.
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| 9. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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Applying MeSH® to the (Swedish) Clinical Domain - Evaluation and Lessons learned
- 2008
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Ingår i: Proceedings of the 6th Scandinavian Health Informatics and the 12th Swedish National Term Conference.
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Konferensbidrag (refereegranskat)abstract
- Medical discharge summaries and clinical notes provide an information rich, nearly unexplored corpus of evidential knowledge that is considered as a potential goldmine for both medical scientists as well as practitioners in the language technology field. The capability to extract the key concepts and their relationships from such data can be of great value for knowledge management tasks such as indexing, data interchange, data aggregation and clinical decision support. The purpose of this work is to get insights into the feasibility of applying the content of a controlled vocabulary, the Medical Subject Headings (MeSH) to a sample of electronic discharge letters (i.e. free text clinical notes). We explore the application of natural language processing (NLP) techniques to the challenge of efficiently detecting the terminology, as encoded in MeSH and we evaluate MeSH in this setting, showing that a lot of work remains to be done in order to increase the coverage of the resource both in terms of its breadth and depth.
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| 10. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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Identification of Entity References in Hospital Discharge Letters
- 2007
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Ingår i: Proceedings of the 16th Nordic Conference of Computational Linguistics (NODALIDA).
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Tidskriftsartikel (refereegranskat)abstract
- In the era of the Electronic Health Record the release of medical narrative textual data for research, for health care statistics, for monitoring of new diagnostic tests and for tracking disease outbreak alerts imposes tough restrictions by various public authority bodies for the protection of (patient) privacy. In this paper we present a system for automatic identification of named entities in Swedish clinical free text, in the form of discharge letters, by applying generic named entity recognition technology with minor adaptations
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| 11. |
- Lee, Byung-Boong, et al.
(författare)
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Venous hemodynamic changes in lower limb venous disease : the UIP consensus according to scientific evidence
- 2016
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Ingår i: International Journal of Angiology. - : Springer. - 0392-9590 .- 1827-1839. ; 35:3, s. 236-352
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Tidskriftsartikel (refereegranskat)abstract
- There are excellent guidelines for clinicians to manage venous diseases but few reviews to assess their hemodynamic background. Hemodynamic concepts that evolved in the past have largely remained unchallenged in recent decades, perhaps due to their often complicated nature and in part due to emergence of new diagnostic techniques. Duplex ultrasound scanning and other imaging techniques which evolved in the latter part of the 20th century have dominated investigation. They have greatly improved our understanding of the anatomical patterns of venous reflux and obstruction. However, they do not provide the physiological basis for understanding the hemodynamics of flow, pressure, compliance and resistance. Hemodynamic investigations appear to provide a better correlation with post-treatment clinical outcome and quality of life than ultrasound findings. There is a far better prospect for understanding the complete picture of the patient's disability and response to management by combining ultrasound with hemodynamic studies. Accordingly, at the instigation of Dr Angelo Scuderi, the Union Internationale de Phlebologie (UIP) executive board commissioned a large number of experts to assess all aspects of management for venous disease by evidence-based principles. These included experts from various member societies including the European Venous Forum (EVF), American Venous Forum (AVF), American College of Phlebology (ACP) and Cardiovascular Disease Educational and Research Trust (CDERT). Their aim was to confirm or dispel long-held hemodynamic principles and to provide a comprehensive review of venous hemodynamic concepts underlying the pathophysiology of lower limb venous disorders, their usefulness for investigating patients and the relevant hemodynamic changes associated with various forms of treatment. Chapter 1 is devoted to basic hemodynamic concepts and normal venous physiology. Chapter 2 presents the mechanism and magnitude of hemodynamic changes in acute deep vein thrombosis indicating their pathophysiological and clinical significance. Chapter 3 describes the hemodynamic changes that occur in different classes of chronic venous disease and their relation to the anatomic extent of disease in the macrocirculation and microcirculation. The next four chapters (Chapters 4-7) describe the hemodynamic changes resulting from treatment by compression using different materials, intermittent compression devices, pharmacological agents and finally surgical or endovenous ablation. Chapter 8 discusses the unique hemodynamic features associated with alternative treatment techniques used by the CHIVA and ASVAL. Chapter 9 describes the hemodynamic effects following treatment to relieve pelvic reflux and obstruction. Finally, Chapter 10 demonstrates that contrary to general belief there is a moderate to good correlation between certain hemodynamic measurements and clinical severity of chronic venous disease. The authors believe that this document will be a timely asset to both clinicians and researchers alike. It is directed towards surgeons and physicians who are anxious to incorporate the conclusions of research into their daily practice. It is also directed to postgraduate trainees, vascular technologists and bioengineers, particularly to help them understand the hemodynamic background to pathophysiology, investigations and treatment of patients with venous disorders. Hopefully it will be a platform for those who would like to embark on new research in the field of venous disease.
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| 15. |
- Thurin, Anders, et al.
(författare)
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Shallow linguistic analysis of a large corpus of drug prescriptions.
- 2002
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Ingår i: Health data in the information society. - Amsterdam : IOS Press. - 1586032798 ; 90, s. 411-5
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Konferensbidrag (refereegranskat)abstract
- We report on first experiences from linguistic analyses of patient instructions from 19,8404 actual drug prescriptions regarding seven pharmaceutical products frequently prescribed in Sweden. The analysis includes expressions for amount, dose unit, dose interval, mode of administration, purpose and a few further details. Even simple processing seems useful to extract information from these short, rather formal text strings. We estimate the potential for calculation of prescribed dose from this material, and collected material gives a good starting point for more advanced linguistic analyses.
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