Methods Inf Med - Statistical process control for monitoring standardized mortality ratios of a classification tree model.


{ age(1611) year(1155) adult(843) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2341) predict(2261) use(1141) }
{ time(1939) patient(1703) rate(768) }
{ measur(2081) correl(1212) valu(896) }
{ assess(1506) score(1403) qualiti(1306) }
{ bind(1733) structur(1185) ligand(1036) }
{ chang(1828) time(1643) increas(1301) }
{ howev(809) still(633) remain(590) }
{ perform(1367) use(1326) method(1137) }
{ signal(2180) analysi(812) frequenc(800) }
{ high(1669) rate(1365) level(1280) }
{ import(1318) role(1303) understand(862) }
{ cost(1906) reduc(1198) effect(832) }
{ result(1111) use(1088) new(759) }
{ model(3404) distribut(989) bayesian(671) }
{ system(1976) rule(880) can(841) }
{ featur(3375) classif(2383) classifi(1994) }
{ take(945) account(800) differ(722) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ extract(1171) text(1153) clinic(932) }
{ case(1353) use(1143) diagnosi(1136) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ research(1218) medic(880) student(794) }
{ group(2977) signific(1463) compar(1072) }
{ use(1733) differ(960) four(931) }
{ implement(1333) system(1263) develop(1122) }
{ activ(1452) weight(1219) physic(1104) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ treatment(1704) effect(941) patient(846) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ care(1570) inform(1187) nurs(1089) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ data(3963) clinic(1234) research(1004) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ state(1844) use(1261) util(961) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }


JECTIVES: The ratio of observed to expected mortality (standardized mortality ratio, SMR), is a key indicator of quality of care. We use PreControl Charts to investigate SMR behavior over time of an existing tree-model for predicting mortality in intensive care units (ICUs) and its implications for hospital ranking. We compare the results to those of a logistic regression model.METHODS: We calculated SMRs of 30 equally-sized consecutive subsets from a total of 12,143 ICU patients aged 80 years or older and plotted them on a PreControl Chart. We calculated individual hospital SMRs in 2009, with and without repeated recalibration of the models on earlier data.RESULTS: The overall SMR of the tree-model was stable over time, in contrast to logistic regression. Both models were stable after repeated recalibration. The overall SMR of the tree on the whole validation set was statistically significantly different (SMR 1.00 ? 0.012 vs. 0.94 ? 0.01) and worse in performance than the logistic regression model (AUC 0.76 ? 0.005 vs. 0.79 ? 0.004; Brier score 0.17 ? 0.012 vs. 0.16 ? 0.010). The individual SMRs' range in 2009 was 0.53-1.31 for the tree and 0.64-1.27 for logistic regression. The proportion of individual hospitals with SMR >1, hinting at poor quality of care, reduced from 38% to 29% after recalibration for the tree, and increased from 15% to 35% for logistic regression.CONCLUSIONS: Although the tree-model has seemingly a longer shelf life than the logistic regression model, its SMR may be less useful for quality of care assessment as it insufficiently responds to changes in the population over time.

Resumo Limpo

jectiv ratio observ expect mortal standard mortal ratio smr key indic qualiti care use precontrol chart investig smr behavior time exist treemodel predict mortal intens care unit icus implic hospit rank compar result logist regress modelmethod calcul smrs equallys consecut subset total icu patient age year older plot precontrol chart calcul individu hospit smrs without repeat recalibr model earlier dataresult overal smr treemodel stabl time contrast logist regress model stabl repeat recalibr overal smr tree whole valid set statist signific differ smr vs wors perform logist regress model auc vs brier score vs individu smrs rang tree logist regress proport individu hospit smr hint poor qualiti care reduc recalibr tree increas logist regressionconclus although treemodel seem longer shelf life logist regress model smr may less use qualiti care assess insuffici respond chang popul time

Resumos Similares

IEEE J Biomed Health Inform - Identification of the Best Anthropometric Predictors of Serum High- and Low-Density Lipoproteins Using Machine Learning. ( 0,771969151073856 )
Comput Math Methods Med - Risk factors for mortality among 2009 A/H1N1 influenza hospitalizations in Maricopa County, Arizona, April 2009 to March 2010. ( 0,753206815032172 )
Int J Health Geogr - Association of duration of residence in the southeastern United States with chronic kidney disease may differ by race: the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study. ( 0,740027189795409 )
J Clin Monit Comput - Influence of age and gender on autonomic regulation of heart. ( 0,697066889871246 )
Comput Math Methods Med - Use of CHAID decision trees to formulate pathways for the early detection of metabolic syndrome in young adults. ( 0,690924969222695 )
Med Decis Making - Subjective numeracy and preference to stay with the status quo. ( 0,68967959321891 )
Int J Comput Assist Radiol Surg - Use of normative distribution of gray to white matter ratio in orthogonal planes in human brain studies and computer-assisted neuroradiology. ( 0,686958144988083 )
J. Med. Internet Res. - Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties. ( 0,684066045964676 )
Int J Health Geogr - Spatial variability of climate effects on ischemic heart disease hospitalization rates for the period 1989-2006 in Quebec, Canada. ( 0,683640704589764 )
Telemed J E Health - Men calling healthline. ( 0,681245668123233 )
J Telemed Telecare - Use of a homecare electronic health record to find associations between patient characteristics and re-hospitalizations in patients with heart failure using telehealth. ( 0,678459387096327 )
Int J Health Geogr - Characteristics of residential areas and transportational walking among frail and non-frail Dutch elderly: does the size of the area matter? ( 0,677357267829979 )
Comput. Biol. Med. - Indicators of hypertriglyceridemia from anthropometric measures based on data mining. ( 0,670715702844244 )
Med Biol Eng Comput - Recurring patterns in stationary intervals of abdominal uterine electromyograms during gestation. ( 0,668555354742082 )
BMC Med Inform Decis Mak - Increasing utilization of Internet-based resources following efforts to promote evidence-based medicine: a national study in Taiwan. ( 0,662224821372355 )
J Am Med Inform Assoc - Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access. ( 0,661797240793098 )
J. Med. Internet Res. - The digital divide among low-income homebound older adults: Internet use patterns, eHealth literacy, and attitudes toward computer/Internet use. ( 0,657650810603014 )
J Am Med Inform Assoc - The impact of electronic health records on care of heart failure patients in the emergency room. ( 0,655442164074893 )
Health Informatics J - Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden. ( 0,647597958550166 )
Telemed J E Health - Home telehealth in high-risk dialysis patients: a 3-year study. ( 0,645071683703778 )
Int J Health Geogr - Changing patterns in the association between regional socio-economic context and dental caries experience according to gender and age: a multilevel study in Korean adults. ( 0,644131461864988 )
Med Decis Making - Health-Related Quality of Life in HIV-Infected and At-Risk Women: The Impact of Illicit Drug Use and Hepatitis C on a Community Preference Weighted Measure. ( 0,642456173893327 )
Comput. Biol. Med. - Prediction of metabolic syndrome using artificial neural network system based on clinical data including insulin resistance index and serum adiponectin. ( 0,638575789218812 )
Telemed J E Health - A retrospective study on patient characteristics and telehealth alerts indicative of key medical events for heart failure patients at a home health agency. ( 0,638023583677962 )
Med Biol Eng Comput - Quantitative geometric analysis of rib, costal cartilage and sternum from childhood to teenagehood. ( 0,634557034640258 )
J. Med. Internet Res. - Recruitment via the Internet and social networking sites: the 1989-1995 cohort of the Australian Longitudinal Study on Women's Health. ( 0,629662800137318 )
Int J Health Geogr - Spatial epidemiology of dry eye disease: findings from South Korea. ( 0,627352470221628 )
J Am Med Inform Assoc - Using electronic health record data to develop inpatient mortality predictive model: Acute Laboratory Risk of Mortality Score (ALaRMS). ( 0,627126662940303 )
J. Med. Internet Res. - Personal health record reach in the Veterans Health Administration: a cross-sectional analysis. ( 0,626365036494552 )
Telemed J E Health - A U.K. case study of who uses NHS direct: investigating the impact of age, gender, and deprivation on the utilization of NHS direct. ( 0,622552093185727 )
Spat Spatiotemporal Epidemiol - Imputational modeling of spatial context and social environmental predictors of walking in an underserved community: the PATH trial. ( 0,62231472592495 )
Spat Spatiotemporal Epidemiol - The association between the density of retail tobacco outlets, individual smoking status, neighbourhood socioeconomic status and school locations in New South Wales, Australia. ( 0,620968992759083 )
AMIA Annu Symp Proc - Integrating public data sets for analysis of maternal airborne environmental exposures and stillbirth. ( 0,62053243876118 )
Int J Health Geogr - Generating GPS activity spaces that shed light upon the mobility habits of older adults: a descriptive analysis. ( 0,620024938708428 )
J. Med. Internet Res. - Online health-searching behavior among HIV-seropositive and HIV-seronegative men who have sex with men in the Baltimore and Washington, DC area. ( 0,617290227675335 )
Int J Health Geogr - Neighborhood level risk factors for type 1 diabetes in youth: the SEARCH case-control study. ( 0,615447020689663 )
Int J Health Geogr - A case-referent study: light at night and breast cancer risk in Georgia. ( 0,614524293963088 )
J Clin Monit Comput - Cardiac output assessed by non-invasive monitoring is associated with ECG changes in children with critical asthma. ( 0,614168666478155 )
Int J Health Geogr - People living in hilly residential areas in metropolitan Perth have less diabetes: spurious association or important environmental determinant? ( 0,611163263787584 )
J Telemed Telecare - An economic analysis of a nurse-led telephone triage service. ( 0,609171991059489 )
J. Med. Internet Res. - Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey. ( 0,605948968376025 )
Int J Med Inform - Using EHR data to predict hospital-acquired pressure ulcers: a prospective study of a Bayesian Network model. ( 0,605631823951937 )
Artif Intell Med - Prediction of body mass index status from voice signals based on machine learning for automated medical applications. ( 0,60556647533087 )
J Clin Monit Comput - Isocapnic hyperpnea with a portable device in Cystic Fibrosis: an agreement study between two different set-up modalities. ( 0,602183200517337 )
Comput. Biol. Med. - Neural network analysis of employment history as a risk factor for prostate cancer. ( 0,601391038894649 )
BMC Med Inform Decis Mak - Impact of computerized physician order entry (CPOE) system on the outcome of critically ill adult patients: a before-after study. ( 0,599238382866967 )
J Med Syst - Migration of patients between five urban teaching hospitals in Chicago. ( 0,594650889214322 )
Comput Math Methods Med - Association of perceived stress with stressful life events, lifestyle and sociodemographic factors: a large-scale community-based study using logistic quantile regression. ( 0,594486631720946 )
Med Decis Making - Rating the preferences for potential harms of treatments for cardiovascular disease: a survey of community-dwelling adults. ( 0,587618271405693 )
Comput. Biol. Med. - A preliminary study on the differences in male and female muscle force distribution patterns during squatting and lunging maneuvers. ( 0,586032034249134 )
Med Biol Eng Comput - Quantitative differences in intervertebral disc-matrix composition with age-related degeneration. ( 0,584989687139804 )
Med Decis Making - The utility of childhood and adolescent obesity assessment in relation to adult health. ( 0,581793609062423 )
Comput Methods Programs Biomed - Development of a daily mortality probability prediction model from Intensive Care Unit patients using a discrete-time event history analysis. ( 0,57992756423036 )
Med Decis Making - Efficacy of phototherapy for newborns with hyperbilirubinemia: a cautionary example of an instrumental variable analysis. ( 0,578886237169918 )
AMIA Annu Symp Proc - Facilitating Clinical Research through the Health Information Exchange: Lipid Control as an Example. ( 0,575765811341338 )
J. Med. Internet Res. - Determinants of follow-up participation in the Internet-based European influenza surveillance platform Influenzanet. ( 0,575494302984742 )
Med Decis Making - Thinking about numbers is not my idea of fun: need for cognition mediates age differences in numeracy performance. ( 0,575432464011709 )
J. Med. Internet Res. - Subdividing the digital divide: differences in internet access and use among rural residents with medical limitations. ( 0,574008762657427 )
BMC Med Inform Decis Mak - Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups. ( 0,573472763978282 )
J. Med. Internet Res. - How an online intervention to prevent excessive gestational weight gain is used and by whom: a randomized controlled process evaluation. ( 0,572949492363954 )
Telemed J E Health - Characteristics of patients who seek care via eVisits instead of office visits. ( 0,57139999545116 )
Int J Med Inform - Older adults: are they ready to adopt health-related ICT? ( 0,568956791652014 )
Int J Med Robot - Outpatient robotic hysterectomy: clinical outcomes and financial analysis of initial experience. ( 0,568210648055799 )
J Telemed Telecare - Sensitivity and specificity of telemedicine-based long-term pulse-oximetry in comparison with cardiorespiratory polygraphy and polysomnography in patients with obstructive sleep apnoea syndrome. ( 0,566683179347438 )
J. Med. Internet Res. - Patient ability and willingness to participate in a web-based intervention to improve hypertension control. ( 0,565285549201391 )
Int J Health Geogr - Neighborhood food environment and body mass index among Japanese older adults: results from the Aichi Gerontological Evaluation Study (AGES). ( 0,564973302504987 )
Med Decis Making - Modeling and validating the cost and clinical pathway of colorectal cancer. ( 0,564408227539987 )
J Am Med Inform Assoc - Clinician characteristics and use of novel electronic health record functionality in primary care. ( 0,564137210089859 )
Appl Clin Inform - Computerized provider order entry reduces length of stay in a community hospital. ( 0,563248723452542 )
BMC Med Inform Decis Mak - Method for Assigning Priority Levels in Acute Care (MAPLe-AC) predicts outcomes of acute hospital care of older persons--a cross-national validation. ( 0,562055797094877 )
BMC Med Inform Decis Mak - Combinational risk factors of metabolic syndrome identified by fuzzy neural network analysis of health-check data. ( 0,561583292085365 )
Int J Health Geogr - Where they live, how they play: neighborhood greenness and outdoor physical activity among preschoolers. ( 0,561457734966052 )
Health Informatics J - Development of an automated model to predict the risk of elderly emergency medical admissions within a month following an index hospital visit: a Hong Kong experience. ( 0,560914471797768 )
Artif Intell Med - Predictive modelling of survival and length of stay in critically ill patients using sequential organ failure scores. ( 0,560479744772025 )
J Telemed Telecare - Spanish-speaking patients' engagement in interactive voice response (IVR) support calls for chronic disease self-management: data from three countries. ( 0,560183202605814 )
BMC Med Inform Decis Mak - Computerized prediction of intensive care unit discharge after cardiac surgery: development and validation of a Gaussian processes model. ( 0,559320862949786 )
Int J Health Geogr - The proportion of youths' physical inactivity attributable to neighbourhood built environment features. ( 0,558542032310942 )
Healthc (Amst) - Contributors to variation in hospital spending for critically ill patients with sepsis. ( 0,558379704406477 )
Methods Inf Med - Early illness recognition using in-home monitoring sensors and multiple instance learning. ( 0,556798235679976 )
Appl Clin Inform - Patient no-show predictive model development using multiple data sources for an effective overbooking approach. ( 0,555195680912978 )
AMIA Annu Symp Proc - A clinical decision tool for predicting patient care characteristics: patients returning within 72 hours in the emergency department. ( 0,553728134960468 )
AMIA Annu Symp Proc - Development and implementation of a real-time 30-day readmission predictive model. ( 0,551145198175333 )
Int J Health Geogr - Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene? ( 0,550052871723714 )
J Med Syst - An acoustical evaluation of knee sound for non-invasive screening and early detection of articular pathology. ( 0,549842021792377 )
Int J Health Geogr - Spatial autocorrelation in uptake of antenatal care and relationship to individual, household and village-level factors: results from a community-based survey of pregnant women in six districts in western Kenya. ( 0,548381391483906 )
Appl Clin Inform - A distribution-based method for assessing the differences between clinical trial target populations and patient populations in electronic health records. ( 0,546749500579894 )
J Biomed Inform - Development and validation of a continuous measure of patient condition using the Electronic Medical Record. ( 0,54485917394028 )
J Biomed Inform - Method selection and adaptation for distributed monitoring of infectious diseases for syndromic surveillance. ( 0,544451587807814 )
J. Med. Internet Res. - Internet use among older adults: association with health needs, psychological capital, and social capital. ( 0,543757115618188 )
Telemed J E Health - Comparative effectiveness study to assess two examination modalities used to detect dental caries in preschool urban children. ( 0,543151372164792 )
BMC Med Inform Decis Mak - Detecting referral and selection bias by the anonymous linkage of practice, hospital and clinic data using Secure and Private Record Linkage (SAPREL): case study from the evaluation of the Improved Access to Psychological Therapy (IAPT) service. ( 0,542071760966468 )
Methods Inf Med - Does Co-morbidity provide significant improvement on age adjustment when predicting medical outcomes? ( 0,541910994872931 )
J. Med. Internet Res. - Impact of the presence of medical equipment in images on viewers' perceptions of the trustworthiness of an individual on-screen. ( 0,541539700505267 )
AMIA Annu Symp Proc - Early detection of sepsis in the emergency department using Dynamic Bayesian Networks. ( 0,54062076094964 )
Med Decis Making - Health status utilities in pediatrics: a systematic review of acute lymphoblastic leukemia. ( 0,539069258485859 )
J Innov Health Inform - Characteristics of electronic patient-provider messaging system utilisation in an urban health care organisation. ( 0,539047424456744 )
Telemed J E Health - Older people's attitudes toward interactive voice response systems. ( 0,538387659832111 )
J. Med. Internet Res. - Who participates in Web-assisted tobacco interventions? The QUIT-PRIMO and National Dental Practice-Based Research Network Hi-Quit studies. ( 0,537388795038867 )
J. Med. Internet Res. - Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis. ( 0,535980074287437 )
J. Med. Internet Res. - Online schools and children with special health and educational needs: comparison with performance in traditional schools. ( 0,535645928992233 )