Academic literature on the topic 'Patient Outcome Optimization'
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Journal articles on the topic "Patient Outcome Optimization"
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Drusano, G. L., and Arnold Louie. "Optimization of Aminoglycoside Therapy." Antimicrobial Agents and Chemotherapy 55, no. 6 (2011): 2528–31. http://dx.doi.org/10.1128/aac.01314-10.
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ABSTRACTAminoglycosides are experiencing a resurgence in use because of the spread of multiresistant Gram-negative pathogens. Use of these agents is attended by the occurrence of nephrotoxicity. Aminoglycoside optimization of dose can be defined as the dose having the highest likelihood of a good outcome and the lowest likelihood of toxicity. We have defined the metric Δ as the difference between the likelihoods of good outcome and toxicity, with higher values being better. We developed a method for explicitly evaluating Δ for different daily doses of drug and different schedules of administration. In the empirical therapy setting, when aminoglycosides are administered every 12 h, treatment of infections caused by microbes with MIC values greater than 1 mg/liter cannot attain a high enough likelihood of a good outcome without engendering an unacceptable toxicity likelihood. Daily administration, by decrementing the likelihood of toxicity, allows higher doses to be employed with more acceptable probabilities of toxicity. Obtaining patient-specific information (concentration-time data) allows better identification of the patient's specific pharmacokinetic parameters and dispersion. As these become better identified, optimal doses become rapidly identified so that optimal outcomes are attained. Optimization of therapy for aminoglycosides requires understanding the relationship between exposure and response as well as that between exposure and toxicity. Furthermore, daily administration is much preferred, and stopping therapy as quickly as possible (a week or less may be optimal) will contribute to the ability to optimize therapy.
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Aghaebrahim, Amin, Christopher Streib, Srikant Rangaraju, et al. "Streamlining door to recanalization processes in endovascular stroke therapy." Journal of NeuroInterventional Surgery 9, no. 4 (2016): 340–45. http://dx.doi.org/10.1136/neurintsurg-2016-012324.
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BackgroundIn acute stroke due to large vessel occlusion, faster reperfusion leads to better outcomes. We analyzed the effect of optimization steps aimed to reduce treatment delays at our center.MethodsConsecutive patients with ischemic stroke treated with endovascular therapy were prospectively analyzed. We divided the patients into pre-optimization (20 April 2012 to 8 October 2013) and post-optimization (9 October 2013 to 29 July 2014) periods. The main interventions included: (1) continuous feedback; (2) standardized immediate emergency department attending to stroke attending communication with interventional team activation for all potential interventions; (3) pre-notification by the emergency medical service; (4) minimizing additional diagnostic testing; (5) direct transport to the CT scanner; (6) transport directly from the CT scanner to the angiography suite. The main metric used to measure improvement was door to groin puncture time (D2P).ResultsWe included a total of 286 patients (178 pre-optimization, 108 post-optimization). There were no significant differences between major baseline characteristics between the groups with the exception of higher median CT Alberta Stroke Program Early CT Score in the pre-optimization group (p=0.01). Median D2P improved from 105 min pre-optimization to 67 min post-optimization (p=0.0002). Rates of good clinical outcomes (modified Rankin Scale 0–2 at 3 months) were similar in both groups, with a trend toward a better outcome in the post-optimization group in a subgroup analysis of patients with anterior circulation occlusion who received intravenous tissue plasminogen activator.ConclusionsThis pilot study demonstrates that D2P times can be significantly reduced with a standardized multidisciplinary approach. There was no significant difference in the rate of 3-month good outcome, which is most likely due to the small sample size and confounding baseline patient characteristics.
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Johnson, Brett C. "Achieving Patient Satisfaction: The Relationship Between Human Motivation and Outcome Optimization." Journal For Healthcare Quality 18, no. 2 (1996): 4–9. http://dx.doi.org/10.1111/j.1945-1474.1996.tb00826.x.
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Freedman, Mark S., David G. Patry, François Grand'Maison, Mary Lou Myles, Donald W. Paty, and Daniel H. Selchen. "Treatment Optimization in Multiple Sclerosis." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 31, no. 2 (2004): 157–68. http://dx.doi.org/10.1017/s0317167100053804.
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AbstractThe treatment of multiple sclerosis has finally become possible with the advent of the current disease-modifying therapies (DMTs) that have had a significant impact on those living with this disease. Though demonstrating clear efficacy on a number of short-term outcome measures, unfortunately, these agents are not “cures” and many patients with multiple sclerosis continue to experience disease activity in spite of treatment. Clinicians are becoming more comfortable initiating therapy with DMTs, but it is now important to focus attention on monitoring the results of the chosen therapy and deciding whether or not a patient is responding well to treatment. At present, however, clinicians lack criteria for defining optimal versus suboptimal responses to DMTs as well as evidence-based guidelines on how to improve treatment outcomes. Using a recently published model as a framework, The Canadian Multiple Sclerosis Working Group developed practical recommendations on how neurologists can assess the status of patients on DMTs and decide when it may be necessary to modify treatment in order to optimize outcomes. The Canadian Multiple Sclerosis Working Group's recommendations are based on monitoring relapses, neurological progression and MRI activity. Other possible causes of suboptimal treatment responses or treatment failure are also considered.
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Dimmer, Alexandra, Robert Baird, and Pramod Puligandla. "Role of practice standardization in outcome optimization for CDH." World Journal of Pediatric Surgery 7, no. 2 (2024): e000783. http://dx.doi.org/10.1136/wjps-2024-000783.
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Standardization of care seeks to improve patient outcomes and healthcare delivery by reducing unwanted variations in care as well as promoting the efficient and effective use of healthcare resources. There are many types of standardization, with clinical practice guidelines (CPGs), based on a stringent assessment of evidence and expert consensus, being the hallmark of high-quality care. This article outlines the history of CPGs, their benefits and shortcomings, with a specific focus on standardization efforts as it relates to congenital diaphragmatic hernia management.
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Gulley, Morgan, Matthew Watson, Catherine Olinger, and Andrew Pugely. "Patient-reported outcome collection standardization and optimization in an academic orthopedic clinic." Advances in Patient-Reported Outcomes 1, no. 1 (2025): 100018. https://doi.org/10.1016/j.apro.2025.100018.
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d’Abadie, Philippe, Stephan Walrand, Renaud Lhommel, Michel Hesse, Ivan Borbath, and François Jamar. "Optimization of the Clinical Effectiveness of Radioembolization in Hepatocellular Carcinoma with Dosimetry and Patient-Selection Criteria." Current Oncology 29, no. 4 (2022): 2422–34. http://dx.doi.org/10.3390/curroncol29040196.
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Selective internal radiation therapy (SIRT) is part of the treatment strategy for hepatocellular carcinoma (HCC). Strong clinical data demonstrated the effectiveness of this therapy in HCC with a significant improvement in patient outcomes. Recent studies demonstrated a strong correlation between the tumor response and the patient outcome when the tumor-absorbed dose was assessed by nuclear medicine imaging. Dosimetry plays a key role in predicting the clinical response and can be optimized using a personalized method of activity planning (multi-compartmental dosimetry). This paper reviews the main clinical results of SIRT in HCC and emphasizes the central role of dosimetry for improving it effectiveness. Moreover, some patient and tumor characteristics predict a worse outcome, and toxicity related to SIRT treatment of advanced HCC patient selection based on the performance status, liver function, tumor characteristics, and tumor targeting using technetium-99m macro-aggregated albumin scintigraphy can significantly improve the clinical performance of SIRT.
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Mosa, Diana T., Amena Mahmoud, John Zaki, Shaymaa E. Sorour, Shaker El-Sappagh, and Tamer Abuhmed. "Henry gas solubility optimization double machine learning classifier for neurosurgical patients." PLOS ONE 18, no. 5 (2023): e0285455. http://dx.doi.org/10.1371/journal.pone.0285455.
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This study aims to predict head trauma outcome for Neurosurgical patients in children, adults, and elderly people. As Machine Learning (ML) algorithms are helpful in healthcare field, a comparative study of various ML techniques is developed. Several algorithms are utilized such as k-nearest neighbor, Random Forest (RF), C4.5, Artificial Neural Network, and Support Vector Machine (SVM). Their performance is assessed using anonymous patients’ data. Then, a proposed double classifier based on Henry Gas Solubility Optimization (HGSO) is developed with Aquila optimizer (AQO). It is implemented for feature selection to classify patients’ outcome status into four states. Those are mortality, morbidity, improved, or the same. The double classifiers are evaluated via various performance metrics including recall, precision, F-measure, accuracy, and sensitivity. Another contribution of this research is the original use of hybrid technique based on RF-SVM and HGSO to predict patient outcome status with high accuracy. It determines outcome status relationship with age and mode of trauma. The algorithm is tested on more than 1000 anonymous patients’ data taken from a Neurosurgical unit of Mansoura International Hospital, Egypt. Experimental results show that the proposed method has the highest accuracy of 99.2% (with population size = 30) compared with other classifiers.
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Sai Sharan Reddy Mittapelly. "Seamless journey to care: The rideshare integration pathway for patient access." World Journal of Advanced Engineering Technology and Sciences 15, no. 3 (2025): 889–96. https://doi.org/10.30574/wjaets.2025.15.3.0958.
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The integration of electronic health record (EHR) systems like Epic with ride-sharing platforms presents a promising solution to one of healthcare's most persistent challenges: patient transportation barriers. This article explores a comprehensive framework for implementing such integration, addressing technical architecture requirements, data privacy considerations, artificial intelligence applications, and outcome assessment methodologies. The article analysis explores how transportation barriers disproportionately affect vulnerable populations and examines the potential of digital health-mobility partnerships to improve appointment adherence and clinical outcomes. Technical implementation models for Epic integration with ride-sharing services are evaluated, with particular attention to HIPAA compliance and data security. The article further shows how artificial intelligence enhances transportation coordination through predictive scheduling, patient risk identification, and resource optimization. Finally, outcome metrics, cost-benefit frameworks, sustainable funding models, and future expansion pathways are discussed, providing healthcare organizations with actionable insights for implementing integrated transportation solutions to improve healthcare access, operational efficiency, and patient outcomes.
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Jaberizadeh, Leva, Jasmine Peterson, and Stephanie Thrall. "Improving efficiency through workflow optimization in a pharmacist-run diabetes clinic." American Journal of Health-System Pharmacy 77, no. 19 (2020): 1606–11. http://dx.doi.org/10.1093/ajhp/zxaa193.
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Abstract Purpose To evaluate the impact of hiring nonclinical support staff on pharmacist productivity and diabetes control outcomes in internal medicine clinics of an integrated healthcare system. Methods A retrospective, longitudinal cohort study was conducted. Patients were included if they were contacted by telephone for a diabetes consultation with a clinical pharmacist from July 1, 2015, through June 30, 2017. Nonclinical support staff were hired in July 2016 to schedule patient appointments with the clinical pharmacists. The primary outcome was the average rate of completed telephone encounters per month before and after hiring of nonclinical support staff. The secondary outcome was the mean change in glycated hemoglobin (HbA1c) level in patients who had a laboratory assay completed within 90 days of clinical pharmacist outreach. The tertiary outcome was the call completion rate for scheduled appointments vs unscheduled calls. Results In total, 6,709 patients were included; their average age was 55 years. After the intervention, the mean (SD) rate of completed telephone encounters increased from 61% (3.8%) to 77% (3.5%) (P < 0.001). Small improvements were noted in glycemic control, as measured by the mean (SD) percentage of patients with an HbA1c concentration of <8%, which increased from 31% (5.2%) to 42% (3.0%) (P < 0.001), and the mean (SD) change in average HbA1c concentration, which increased from 8.9% (0.2%) to 8.5% (0.1%) (P < 0.001). Throughout the study, scheduled calls were more likely to be completed than unscheduled calls (mean [SD] completion rate, 66% [9.0%] vs 74% [6.0%]; P < 0.001). Conclusion Hiring nonclinical support staff led to greater efficiency among the clinical pharmacist team, yielding a higher volume of telephone interactions, a modest overall decrease in HbA1c values, and an increased likelihood of reaching patients by phone.
Dissertations / Theses on the topic "Patient Outcome Optimization"
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Peters, Eric. "The pharmacogenetics of antidepressant response moving towards individualized therapy ; improving patient outcomes through optimization of treatment based on genetic makeup." Saarbrücken VDM Verlag Dr. Müller, 2007. http://d-nb.info/989451372/04.
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Assareh, Hassan. "Bayesian hierarchical models in statistical quality control methods to improve healthcare in hospitals." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/53342/1/Hassan_Assareh_Thesis.pdf.
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Quality oriented management systems and methods have become the dominant business and governance paradigm. From this perspective, satisfying customers’ expectations by supplying reliable, good quality products and services is the key factor for an organization and even government. During recent decades, Statistical Quality Control (SQC) methods have been developed as the technical core of quality management and continuous improvement philosophy and now are being applied widely to improve the quality of products and services in industrial and business sectors. Recently SQC tools, in particular quality control charts, have been used in healthcare surveillance. In some cases, these tools have been modified and developed to better suit the health sector characteristics and needs. It seems that some of the work in the healthcare area has evolved independently of the development of industrial statistical process control methods.
Therefore analysing and comparing paradigms and the characteristics of quality control charts and techniques across the different sectors presents some opportunities for transferring knowledge and future development in each sectors. Meanwhile considering capabilities of Bayesian approach particularly Bayesian hierarchical models and computational techniques in which all uncertainty are expressed as a structure of probability, facilitates decision making and cost-effectiveness analyses.
Therefore, this research investigates the use of quality improvement cycle in a health vii setting using clinical data from a hospital. The need of clinical data for monitoring purposes is investigated in two aspects. A framework and appropriate tools from the industrial context are proposed and applied to evaluate and improve data quality in available datasets and data flow; then a data capturing algorithm using Bayesian decision making methods is developed to determine economical sample size for statistical analyses within the quality improvement cycle.
Following ensuring clinical data quality, some characteristics of control charts in the health context including the necessity of monitoring attribute data and correlated quality characteristics are considered. To this end, multivariate control charts from an industrial context are adapted to monitor radiation delivered to patients undergoing diagnostic coronary angiogram and various risk-adjusted control charts are constructed and investigated in monitoring binary outcomes of clinical interventions as well as postintervention survival time.
Meanwhile, adoption of a Bayesian approach is proposed as a new framework in estimation of change point following control chart’s signal. This estimate aims to facilitate root causes efforts in quality improvement cycle since it cuts the search for the potential causes of detected changes to a tighter time-frame prior to the signal. This approach enables us to obtain highly informative estimates for change point parameters since probability distribution based results are obtained.
Using Bayesian hierarchical models and Markov chain Monte Carlo computational methods, Bayesian estimators of the time and the magnitude of various change scenarios including step change, linear trend and multiple change in a Poisson process are developed and investigated.
The benefits of change point investigation is revisited and promoted in monitoring hospital outcomes where the developed Bayesian estimator reports the true time of the shifts, compared to priori known causes, detected by control charts in monitoring rate of excess usage of blood products and major adverse events during and after cardiac surgery in a local hospital.
The development of the Bayesian change point estimators are then followed in a healthcare surveillances for processes in which pre-intervention characteristics of patients are viii affecting the outcomes. In this setting, at first, the Bayesian estimator is extended to capture the patient mix, covariates, through risk models underlying risk-adjusted control charts. Variations of the estimator are developed to estimate the true time of step changes and linear trends in odds ratio of intensive care unit outcomes in a local hospital. Secondly, the Bayesian estimator is extended to identify the time of a shift in mean survival time after a clinical intervention which is being monitored by riskadjusted survival time control charts. In this context, the survival time after a clinical intervention is also affected by patient mix and the survival function is constructed using survival prediction model.
The simulation study undertaken in each research component and obtained results highly recommend the developed Bayesian estimators as a strong alternative in change point estimation within quality improvement cycle in healthcare surveillances as well as industrial and business contexts. The superiority of the proposed Bayesian framework and estimators are enhanced when probability quantification, flexibility and generalizability of the developed model are also considered.
The empirical results and simulations indicate that the Bayesian estimators are a strong alternative in change point estimation within quality improvement cycle in healthcare surveillances. The superiority of the proposed Bayesian framework and estimators are enhanced when probability quantification, flexibility and generalizability of the developed model are also considered. The advantages of the Bayesian approach seen in general context of quality control may also be extended in the industrial and business domains where quality monitoring was initially developed.
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Ciappuccini, Renaud. "Apport de l'imagerie fonctionnelle par TEMP/TDM et TEP/TDM dans la prise en charge des cancers différenciés de la thyroïde Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer Full text links full-text provider logo Actions Favorites Share Page navigation Title & authors Abstract Conflict of interest statement Figures Similar articles Cited by References Related information LinkOut - more resources EJNMMI Res . 2018 Dec 3;8(1):104. doi: 10.1186/s13550-018-0461-x. Optimization of a dedicated protocol using a small-voxel PSF reconstruction for head-and-neck 18 FDG PET/CT imaging in differentiated thyroid cancer 78 Lymph node involvement in head-and-neck and thyroid cancers with digital PET/CT: the impact of ultra-high definition voxels and point-spread function Tumor burden of persistent disease in patients with differentiated thyroid cancer: correlation with postoperative risk-stratification and impact on outcome 133 18F-Fluorocholine PET/CT is a highly sensitive but poorly specific tool for identifying malignancy in thyroid nodules with indeterminate cytology: The Chocolate study PSMA expression in neovasculature of persistent/recurrent differentiated thyroid cancerin the neck: relationship with radioiodine uptake, 18Fluorodeoxyglucose avidity and outcome." Thesis, Normandie, 2020. http://www.theses.fr/2020NORMC424.
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L’imagerie scintigraphique des cancers thyroïdiens différenciés (CTD) présente la particularité d’utiliser deux radiopharmaceutiques, l’iode 131 (131I) et le 18-Fluorodésoxyglucose (18FDG). La fixation de ces traceurs dépend habituellement du degré de différenciation et de l’agressivité de la tumeur. L’objectif de ce travail était d’étudier l’apport de différents aspects techniques et d’instrumentation, à savoir l’imagerie hybride par TEMP/TDM et TEP/TDM, la point-spread function (PSF), la taille des voxels et la technologie TEP digitale, et d’explorer si d’autres traceurs TEP pouvaient présenter un intérêt. Le but de la première partie était d’étudier les performances de la TEP/TDM au 18FDG à l’étage cervical pour la détection de la maladie ganglionnaire. Une acquisition TEP/TDM dédiée a amélioré la détection de la maladie tumorale par rapport à l’acquisition classique. L’utilisation de la PSF a permis de détecter des tailles de lésions plus petites et la durée optimale de cette acquisition a été évaluée. Des reconstructions avec des tailles de voxels ultra-fines ont été réalisées sur TEP digitale pour étudier l’impact de la PSF et des voxels ultra-fins sur les données quantitatives. La seconde partie a porté sur l’imagerie 131I-TEMP/TDM et 18FDG-TEP/TDM, afin de quantifier le volume de la maladie persistante. Il a ainsi été montré que la masse tumorale était corrélée au risque post-opératoire et avait un impact sur la réponse au traitement. L’objectif de la troisième partie était d’étudier un autre traceur TEP, la 18-Fluorocholine (FCH), ainsi qu’un marqueur de la néovascularisation, l’antigène membranaire spécifique de la prostate (PSMA). Nos données suggèrent qu’un examen TEP à la FCH négatif au sein d’un nodule thyroïdien à cytologie indéterminée permettrait d’éliminer la malignité, et pourrait éviter des chirurgies inutiles. Par ailleurs, le marquage au PSMA évalué par immunohistochimie dans les néo-vaisseaux est associé à des facteurs de mauvais pronostic. D’autres études sont nécessaires pour confirmer l’intérêt éventuel des examens TEP à la FCH et au 68Ga-PSMA en oncologie thyroïdienne<br>Radioiodine (131I) and 18-Fluorodeoxyglucose (18FDG) are two radiopharmaceuticals used for scintigraphic imaging in differentiated thyroid cancers (DTC). Tumour uptake of each tracer depends on tumour differentiation and aggressiveness. Our goal was to further assess various technical aspects in DTC imaging workup, such as SPECT/CT and PET/CT, point-spread function (PSF), voxel size, digital PET, and to explore further other PET tracers. The aim of the first part was to assess the performance of 18FDG PET/CT for the detection of neck lymph node involvement. A dedicated PET/CT acquisition improved tumour detection compared to the whole-body acquisition. PSF reconstruction allowed detection of smaller cancer deposits and the optimal acquisition duration time was assessed. Using digital PET acquisitions, ultra-thin voxels reconstructions were performed. The impact of ultra-thin voxels and PSF on quantitative values was evaluated. The second part focused on 131I-SPECT/CT and 18FDG-PET/CT imaging, in an attempt to assess tumour burden of persistent disease. Tumor burden was correlated with the postoperative risk and affected the response to therapy. In the third part, another PET tracer, i.e. 18-Fluorocholine (FCH), and a marker of neovasculature, i.e. prostate-specific membrane antigen (PSMA), were studied. FCH PET/CT offered high negative predictive value to reliably exclude cancer in PET-negative nodules with indeterminate cytology and might prevent unnecessary surgeries. Also, PSMA expression assessed with immunohistochemistry was associated with poor prognosis factors. Further studies are needed to confirm new insights of FCH PET and 68Ga-PSMA PET in DTC
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Werkmeister, Martin Lenard. "Entwicklung und Validierung eines Fragebogens zur Erfassung der kognitiven Dimension gesundheitsbezogener Lebensqualität (COQOL - COgnitive Quality Of Life) bei Menschen mit Demenz." Doctoral thesis, 2019. http://hdl.handle.net/11858/00-1735-0000-002E-E623-3.
Full textBooks on the topic "Patient Outcome Optimization"
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Mythen, Monty, and Michael P. W. Grocott. Peri-operative optimization of the high risk surgical patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0361.
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Flow-based cardiovascular variables, such as cardiac output and oxygen delivery predict peri-operative outcome better than alternative, predominantly pressure-based measures. Targeting flow-based goals, using fluid boluses with or without additional blood or vasoactive agents in patients undergoing major surgery has been shown to improve outcome in some studies. However, the literature is limited due to a large number of small single-centre studies, and heterogeneity of interventions and outcomes evaluated. Early studies used pulmonary artery catheters to monitor blood flow, but newer studies have used less invasive techniques, such as oesophageal Doppler monitoring or pulse contour analysis. Meta-analysis of the current evidence base suggests that this approach is unlikely to cause harm and may not reduce mortality, but reduces complications and duration of hospital stay. Goal-directed therapy is considered an important element of enhanced recovery packages that have been shown to improve outcome after several types of major elective surgery.
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Clarkin, Andrew J., and Nigel R. Webster. Pre-surgical optimization of the high-risk patient. Edited by Neil Soni and Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0088.
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There is a small group of patients undergoing surgery who comprise the majority of perioperative deaths. Morbidity and mortality resulting from tissue hypoxia in the perioperative period can be predicted and prevented by identification of the at-risk group and targeted interventions. Management of these patients requires an understanding of oxygen delivery, the use of cardiac output monitoring to guide fluid and inotrope administration to attain a predefined goal of supranormal oxygen delivery, and the attainment of physiological goals. There are both patient outcome and economic benefits to this management strategy which support the individualized goal-directed therapy approach to managing high-risk patients.
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Cetin, Derrick. Medical Evaluation of the Bariatric Surgery Patient. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0002.
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Evaluation of the obese patient requires identification of all comorbidities and health conditions, including underlying cardiac and pulmonary conditions that could have a negative outcome on noncardiac surgery. Once comorbidities have been recognized, aggressive optimization of these medical conditions can provide improved outcomes after bariatric surgery. Estimating medical risk can be performed by several validated classification systems. The preoperative checklist and clinical practice guidelines (CPG) were updated in 2013. The CPG recommendations for preoperative evaluation of the bariatric surgery patient include lab testing, nutritional screening, endocrine assessment, and cardiopulmonary assessment, including sleep apnea screening. The CPG suggest an extensive multidisciplinary team approach to the preoperative bariatric surgery patient. Finally, the medical evaluation includes an algorithm for a seven-step approach to the preoperative visit. Also recommended for evaluation of the morbidly obese patient is an algorithm that uses a five-step approach after a comprehensive history and physical exam and lab testing.
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Paterson, David L., and Yoshiro Hayashi. Antimicrobial selection policies in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0286.
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Antibiotic selection is a crucial drug choice in critically-ill patients. Optimization of empiric antibiotic choice can be gained by knowledge of the site of infection and the probable causative organisms at that site. This should be linked with knowledge of the local epidemiology of antibiotic resistance in the actual intensive care unit housing the patient. Initial empiric antimicrobial choice may need to be broad in order to cover potential antibiotic-resistant pathogens. However, it is important to be prudent in antibiotic strategy since the selection of multiple-resistant organisms by excessively broad or prolonged antibiotic therapy may affect not just the patient undergoing antibiotic therapy, but also other future patients. Selection of appropriate antibiotic regimens can be facilitated by the use of technology such as MALDI-TOF for rapid bacterial identification. Consultation with infectious disease physicians or specialist pharmacists may also be warranted in order to optimize antibiotic dosing, duration of infusion and frequency of administration, so as to meet pharmacodynamics targets linked to improved patient outcome.
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McAnally, Heath B., Lynda Welton Freeman, and Beth Darnall. Preoperative Optimization of the Chronic Pain Patient. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190920142.001.0001.
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Elective surgery on poorly prepared patients suffering with chronic pain and comorbid substance dependence is increasingly shown to confer suboptimal outcomes—both clinical and economic. Achieving biopsychosocial “fitness for surgery” for these patients often requires a process similar to preoperative optimization of cardiac and other chronic diseases, with modification/elimination of risk factors (in many cases shared with those diseases). These risk factors are not so much genetic or uncontrollable, but rather behavioral, and comprise toxic thoughts and toxic habits. The preoperative optimization program for chronic pain patients presented in this book focuses on high-yield modifiable targets that are supported by the literature and the authors’ clinical experience. These comprise tobacco cessation, preoperative opioid reduction or elimination, slow-wave sleep enhancement, nutritional and exercise “prehabilitation,” and reduction of anxiety and pain catastrophization.
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van Lier, Felix, and Robert Jan Stolker. Preoperative assessment and optimization. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0040.
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Perioperative cardiovascular complications (including myocardial ischaemia and myocardial infarction) are the predominant cause of morbidity and mortality in patients undergoing non-cardiac surgery. The pathophysiology of perioperative myocardial infarction is complex. Prolonged myocardial ischaemia due to the stress of surgery in the presence of a haemodynamically significant coronary lesion, leading to subendocardial ischaemia, and acute coronary artery occlusion after plaque rupture and thrombus formation contribute equally to these devastating events. Perioperative management aims at optimizing the patient’s condition by identification and modification of underlying cardiac risk factors and diseases. The first part of this chapter covers current knowledge on preoperative risk assessment. Current risk indices, the value of additional testing, and new preoperative cardiac risk makers are investigated. During recent decades there has been a shift from the assessment and treatment of the underlying culprit coronary lesion towards a systemic medical therapy aiming at prevention of myocardial oxygen supply–demand mismatch and coronary plaque stabilization. In the second part of this chapter, risk-reduction strategies are discussed, including β-blocker therapy, statins, and aspirins. A central theme in this chapter will focus on long-term cardiovascular risk reduction. Patients who undergo non-cardiac (vascular) surgery are particularly prone to long-term adverse cardiac outcomes. The goal of perioperative cardiovascular risk identification and modification should not be limited to the perioperative period, but should extend well into the postoperative period.
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Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Anaesthesia for major abdominal surgery in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0008.
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Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should be avoided. Elderly patients should receive postoperative care in an environment that is appropriate to the degree of comorbidity and the type of surgery. Effective analgesia is known to improve outcome. Only experienced anaesthetists should manage major and emergency abdominal surgery.
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Rummell, Christina M. Support Groups and Behavioral Science. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0003.
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While a psychological evaluation is often a required part of a weight-loss surgery workup, providers are becoming aware of the need for behavioral health services during each phase of the surgery process. Research has documented a higher prevalence of psychiatric comorbidities in severely obese patient populations, with those who receive behavioral health interventions before surgery having better outcomes than those who do not. Common recommendations and interventions for pre- and postoperative behavioral health optimization are reviewed and discussed.Statistics indicate a greater lifetime prevalence of substance use disorders in weight-loss surgery patients than in the general population. Postoperative complications have been shown to result from substance abuse, making it one of the top-cited contraindications for surgery. Preliminary recommendations for assessing and addressing substance use in bariatric surgery candidates are discussed.
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Morgan, Douglas E. Point-of-Care Testing (DRAFT). Edited by Raghavan Murugan and Joseph M. Darby. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190612474.003.0030.
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Point-of-care testing (POCT) is defined as medical diagnostic testing performed outside the clinical laboratory in close proximity to where the patient is receiving care. POCT is typically performed by non-laboratory personnel and the results are used for clinical decision making. When used appropriately, point-of-care testing (POCT) is a valuable resource during the rapid response system (RRS) activation. Advantages include shortened time between acquiring a sample from the patient and analysis of that sample and a subsequent decrease in time to clinical decision making. Disadvantages revolve largely around the cost of POCT. Driving forces behind the movement towards POCT include care process optimization, improvement of patient outcomes, changing regulatory requirements, and changes in the face of the workforce.
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Alvis, Bret D., and Christopher G. Hughes. Delirium. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0061.
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Delirium in the postoperative period, characterized by inattention, disorganized thinking, disorientation, and/or altered levels of consciousness within the first few days after surgery, has been associated with significant increases in hospital stay, functional decline, prolonged cognitive dysfunction, and mortality. It is underdiagnosed without routine assessments with validated tools such as the Confusion Assessment Method (CAM), the 4AT, the Confusion Assessment Method for Intensive Care Unit (CAM-ICU), or the Intensive Care Delirium Screening Checklist (ICDSC). Prevention strategies for postoperative delirium include multimodal pain control, judicious use of medications that affect the sensorium, including benzodiazepines and anticholinergics, maintenance of appropriate volume status, and optimization of the patient’s environment. In patients who develop delirium with severe agitation, antipsychotic and alpha-2 agonist medications may be useful. Because postoperative delirium occurs commonly and is associated with worse outcomes, an understanding of its disease process, risk factors, and management is essential for an anesthesiologist.
Book chapters on the topic "Patient Outcome Optimization"
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ArunKumar, K., and S. Vasundra. "Prognostic Outcome Prediction on Patient Treatment Trajectory Data Using PSO Optimization on LTSM-RNN Model." In Advances in Intelligent Systems and Computing. Springer Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-7330-6_78.
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Avagyan, Anna, Elya Minasyan, Hamlet Khachatryan, and Smbat Gevorgyan. "Possible Process Optimization: Innovative Digital Health Implementation Models." In Sustainable Development Goals Series. Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-62332-5_10.
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AbstractThe digitization in healthcare faces challenges in LMICs. The success of digital tools depends on having a workforce capable of designing, implementing, and maintaining such tools. Relevant training of professional staff and familiarisation with new tasks are crucial processes for the optimization of digital tools’ performance. In the broader context, interdisciplinary and interprofessional healthcare interventions often focus on outcomes such as length of stay, readmission rates and/or mortality. However, the effects of digital health interventions on these outcomes have been inconsistent in low-and middle-income countries. The current chapter discusses identified challenges in different digital health implementation models. Addressing these challenges and conducting further research and evaluation can contribute to successfully implementing digitization and process optimization in healthcare settings, leading to improved patient outcomes and quality of care.
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McAnally, Heath B. "Scope of the Problem." In Preoperative Optimization of the Chronic Pain Patient. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190920142.003.0001.
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This program and book are predicated on the relationship between chronic preoperative pain and worsened elective surgical outcomes. Preexisting chronic pain and associated factors (e.g., anxiety and pain catastrophizing, poor physical health maintenance, toxic substance use, etc.) predict poor outcomes including increased hospital length of stay and unplanned admissions/readmissions, chronic postsurgical pain (CPSP) and disability, chronic postoperative opioid use and dependence, and even surgical complications and failures. The potential cost of nonoptimized preoperative chronic pain in the context of these various suboptimal outcome measures is staggering and may well run into the tens if not hundreds of billions of dollars.
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Livelsberger, Jon, and Alla Spivak. "Enhanced recovery after bariatric surgery." In Oxford Textbook of Anaesthesia for the Obese Patient, edited by Ashish C. Sinha. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198757146.003.0031.
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The purpose of this chapter is to educate the reader on evidence-based management of surgery in the obese population, including obesity surgery. Included are strategies for patient education, optimization, and management during all phases of care starting with outpatient preoperative visits and ending once the patient has safely recovered from surgery. While the anaesthesiology team often serves to employ many of the management strategies discussed, it is most certainly a multidisciplinary approach. The main purposes are to improve patient experiences, improve patient outcomes, and reduce complications while ensuring that safe universal practices are underway. The final outcome, however, depends on the cooperation of the patient, perioperative team, and any specialized consultants involved.
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Dwivedi, Shweta, Syed Adnan Afaq, Mohammad Faisal, Mohammed Siddique, and Neeraj Kumar Verma. "Transforming Healthcare." In Startup-Driven E-Government. IGI Global, 2025. https://doi.org/10.4018/979-8-3373-0817-3.ch022.
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IoT technologies, combined with machine learning (ML), are revolutionizing healthcare through remote patient monitoring, personalized treatment, and operational optimization. This section defines healthcare IoT, highlighting its attributes and evolution. It examines the impact of wearable sensors, IoT devices, and smart equipment on patient outcomes and clinical processes. The chapter also discusses ML applications in healthcare, focusing on clinical decision support, data processing, and outcome modeling. It explores how ML enhances diagnostics and treatment, integrating IoT for proactive disease management and early intervention. Challenges such as regulatory compliance, data privacy, and system interoperability are addressed, along with future research directions.
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Hügel, Jonas, Jan Janosch Schneider, Daniel Tran Ortega, et al. "A Concept for Mining Transitive Sequential Patterns from Pancreatic Cancer Patient Journeys." In Studies in Health Technology and Informatics. IOS Press, 2024. http://dx.doi.org/10.3233/shti240862.
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Pancreatic cancer, renowned for its aggressive nature and poor prognosis, necessitates the optimization of treatment strategies. The sequence of procedures in clinical trials is critical, such as evaluating the potential benefits of preoperative chemo-radio-therapy for pancreatic cancer. Nevertheless, we might not be aware of other temporal sequences which have an effect on therapy response or the general outcome. Extracting transitive sequential patterns from patients’ medical trajectories allows researchers to identify temporal characteristics for complex diseases. We illustrate how such sequential patterns can be discovered and might be utilized in pancreatic cancer research as well as patient care.
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Hudson, Donald, and Sean Moodley. "Pressure ulcers." In Oxford Textbook of Plastic and Reconstructive Surgery, edited by Andrew Fleming. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780199682874.003.0108.
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Pressure ulcers are a problem worldwide with social and cost implications. Patients at special risk are paraplegics, those in intensive care units who are critically sick, and older patients having prolonged bed rest for whatever reason. The important extrinsic factors are pressure, shear, and friction. There are a number of charts, which endeavour to identify patients at risk, and institute appropriate preventative measures thereby avoiding the long-term sequelae and burden of pressure ulcers. In patients with established pressure ulcers, an accurate patient and wound evaluation is vitally important. The long-term success of management of these ulcers is dependent on good patient rehabilitation and optimization of the wound. Reconstructive success is improved by following surgical guidelines. Use of fasciocutaneous flaps, designed in a V–Y configuration, is the preferred method of reconstruction with muscle flaps reserved as a back-up option. Conscientious postoperative care is equally important at ensuring a successful surgical outcome and minimizing complications
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Elwes, Mayra, Bhanu Prasanna Koppolu, Carminia Lapuz, et al. "From Normal to Optimal: Investigating Metabolic and Inflammatory Parameters as Predictors of Survival in Locally Advanced Cervical Cancer." In Studies in Health Technology and Informatics. IOS Press, 2025. https://doi.org/10.3233/shti250402.
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Cervical cancer is the third most common cancer in women, and recent studies have highlighted the importance of body composition markers in predicting patient outcomes. We build upon the data of 83 patients from the Uterus-11 study, to explore the relation of pairwise feature combinations to long-term progression-free survival. We propose a framework to identify the parameter combinations with pre-defined thresholds of “normal range” which provide good separation of the survival group. Further, we optimize the pair-wise thresholds to further improve the separation measured by F1 scores. This approach allowed us to improve the statistical significance of hazard ratios in comparison to the previous studies. The optimization results suggest that the normal ranges of well-established biomarkers such as body mass index could be shifted in the context of specific diseases to achieve optimal outcome.
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"Bedside care and rehabilitation with mechanical circulatory support and thoracic transplantation." In Cardiopulmonary transplantation and mechanical circulatory support, edited by Maziar Khorsandi, Steven Tsui, John Dark, et al. Oxford University PressOxford, 2022. http://dx.doi.org/10.1093/med/9780192867612.003.0019.
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Abstract Many patients with cardiopulmonary failure suffer from poor mobility and malnutrition in the days and weeks running up to cardiopulmonary transplantation. Physical and psychological deconditioning are serious sequalae of end-stage heart/lung failure and behave in a vicious circle. Furthermore, malnutrition and muscle wasting are a recipe for polymicrobial infectious complications and/or wound breakdown, which in an immunosuppressed patient, could have catastrophic consequences. Early institution of ambulation and nutritional optimization by a dedicated team are critical in the outcome of transplant patients. In this chapter, the importance of ambulation in the immediate postoperative period as well as a planned, regimented physical rehabilitation programme in minimizing such serious sequalae is emphasized.
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Ramalakshmi, K., S. P. Santhoshkumar, L. Krishna Kumari, et al. "Improved Brain Tumor Segmentation Using Min-Max Normalization in a U-Net Architecture." In Integrative Machine Learning and Optimization Algorithms for Disease Prediction. IGI Global Scientific Publishing, 2025. https://doi.org/10.4018/979-8-3373-1087-9.ch010.
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The procedure of manually identifying brain tumors from MRI scans is difficult and time-consuming. It takes a lot of time and work, which increases the possibility of mistakes. Brain tumor segmentation needs to be accurate and consistent in order to be used for cancer identification, treatment scheduling, and outcome estimation. Effective brain tumor segmentation is vital for early brain tumor detection is necessaryfor improving patient prognosis and treatment alternatives. Even with the increasing usage of for brain imaging and the development of AI detection techniques, creating a reliable and effective model to identify and classify cancers from MRI images is still a difficult task. In order to tackle this issue, we suggested an improved UNet based segmentation method for brain tumor partitioning.For brain tumor partitioning, our newly created deep learning-based model performs better than previously developed pre-trained models. The outcomes show that, a dice coefficient of 88.7% and an accuracy of 98.7%, our segmentation model had the best performance.
Conference papers on the topic "Patient Outcome Optimization"
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Baldwin, Mark A., Joseph E. Langenderfer, Jack Farr, and Paul J. Rullkoetter. "Computational Simulation of Anterior-Medial Tibial Tuberosity Transfer: Optimization With Simulated Annealing." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176437.
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Patellofemoral (PF) disorders remain complex and multifactorial. PF pathology, such as PF knee pain, excessive lateral pressure, and PF arthritis have been linked to excessive contact forces and pressure between the patella and femur [1]. Antero-medial transfer of the tibial tuberosity and tibial attachment of the patellar tendon is a procedure that was designed to reduce the PF contact pressure, thereby decreasing pain symptoms of early PF arthritis. The transfer procedure alters the angle between the patellar tendon and the quadriceps muscle force, and increases the patellar moment arm. These changes result in a reduction in the quadriceps force required for a given knee flexion strength, and in reduced contact pressure between the patella and femur. However, the tubercle movement also changes the flexion of the patella in the sagital plane, which alters not only regions of contact at various degrees of motion, but may also alter the contact area at these flexion ranges. PF forces, contact pressures and kinematics have been evaluated both prior to, and following, anteromedialization procedures in several cadaveric studies, e.g. [2]. Computational studies have evaluated the potential of anterior and medial tuberosity transfer to reduce PF contact pressure, including a study utilizing patient-specific models to analyze isolated anterior transfer at 15 and 20 mm, and combined antero-medial transfer at two different treatment levels for single, static flexion positions [3]. However, this study suggested that optimal tuberosity transfer required to decrease contact pressure was widely variable between patients and had less absolute decreases than earlier studies. This variability of contact pressure may translate clinically to patient comfort and thus, to maximize surgical outcome, it is likely necessary to identify a patient-specific parameter. Therefore, the purpose of the present study was to evaluate the feasibility of optimization, specifically simulated annealing, to determine the optimal amounts of anterior and medial transfer of the tibial tuberosity required to minimize peak patellofemoral contact pressure during a deep flexion cycle.
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Miranda, Natalia Figueiredo, Beatriz Medeiros Correa, Raphael Palomo Barreira, et al. "Neurocryptococcosis in immunocompetent patient: Case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.104.
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Context: Cryptococcosis is a systemic fungal infection, which can affect the central nervous system, caused by fungi of the Cryptococcus complex, having as main representatives the species C. neoformans and C. gatti; despite the similarities, these species compose distinct pathologies from the clinical and epidemiological point of view. Objective: To highlight possible diagnosis of cryptococcosis with inferior airway coinfection and CNS in order to elucidate early diagnosis and better clinical outcome. Case Report: A 43-year-old man, healthy, sought emergency care for flu-like symptoms associated with headache. Chest X-ray was performed with findings compatible with pneumonia associated with a single pulmonary nodule on the right base. He evolved with fever, neck stiffness, tonic-clonic seizure and lowering of consciousness level. Magnetic Resonance imaging of the skull was performed with numerous parenchymatic lesions of cystic aspect, perilesional edema and gadolinium ring enhancement. Lumbar puncture with xanthochromic liquor, high opening pressure associated with pleocytosis and cryptococcus gatti growth in culture. The patient progresses with intracranial hypertension associated with cryptococcal meningitis refractory to serial cerequaric punctures with excessive liquoric emptying. Performed external ventricle bypass associated with pharmacological therapy with venous antifungals, without clinical improvement progressing with bacterial meningitis; neurologic intervention was performed with contralateral PVD, without success, with evolution to death. Result: Dramatic evolution even with antibiotic optimization and neurosurgical procedures. Conclusion: There are few case reports about the severity and lethality of c. gattii infections in immunocompetent patients.
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Bhange, Ashish, Abhishek Gulia, Anirudh Punnakal, et al. "Role of interstitial brachytherpy using template (mupit) in locally advanced carcinoma cervix." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685257.
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Introduction: Locally advanced carcinoma cervix includes stages IIB, IIIA, IIIB and IVA. Interstitial brachytherapy has the potential to deliver adequate dose to lateral parametrium and to vagina. Hence, it is preferable in cases with distorted anatomy, extensive (lower) vaginal wall involvement, bulky residual disease post EBRT and parametrium involvement upto lateral pelvic wall. Aim and Objective: To determine clinical outcome and complications (acute and chronic) in locally advanced carcinoma cervix, treated with interstitial brachytherapy using template (MUPIT - Martinez universal perineal interstitial template). Materials and Methods: This study is a retrospective analysis of 37 cases of locally advanced carcinoma cervix (stage IIB-2, IIIB-30, IVA-5), treated with EBRT (dose-median 45Gy/25#) ± concurrent chemotherapy (CCT) - Inj. Cisplatin/Inj Carboplatin, followed by interstitial brachytherapy using MUPIT from December 2009 to June 2015. Initial treatment with EBRT ± CCT was followed by intertstitial brachytherapy. Under spinal anaesthesia and epidural analgesia, MUPIT application was done. Straight and divergent needles (median 26, range 19-29) were inserted to cover parametrium adequately. Needle position was verified with planning CT scan and Brachytherapy planning was done. Dose was normalized to 5 mm box surface from outermost needle with optimization of dose to OAR (Bladder, Rectum and Sigmoid colon). Prescription dose –25Gy in 5#. Treatment was delivered by Microselectron HDR using Ir192 source. Treatment fractions were delivered twice daily with min 6 Hrs. gap in-between fractions. Results: The median duration of follow-up was 25 months. Local control was achieved in 28 patients with residual disease in 7 patients and local recurrence in 2 patients. 10 patients had acute lower GI toxicity {Grade1 (n=6), Grade 2 (n=4)}, 2 patients had acute Grade 1 bladder toxicity. 1 patient had grade 3 and 1 patient had grade 4 chronic bladder toxicity. Chronic rectal toxicity was seen in 10 patients {Grade 2 (n=4), Grade 3 (n=4), Grade 4 (n=2)}. Conclusion: Local control was achieved in 28/37 patients (75.6%) and overall survival rate of 81.1% at median follow up of 25 months in patients with locally advanced carcinoma cervix and unfavorable prognostic factors.
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Joshi, Herat. "AI-Enabled Project Portfolio Management and Selection in the US Healthcare Sector: Maximizing Efficiency and Value." In 12th IPMA Research Conference “Project Management in the Age of Artificial Intelligence”. International Project Management Association – IPMA, IPMA USA, 2024. http://dx.doi.org/10.56889/idnw4314.
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In the US healthcare industry, the use of Artificial Intelligence (AI) in Project Portfolio Management (PPM) has become a vital factor in efficiency, strategic decision-making, and value optimization. By highlighting the important role of AI technologies -machine learning, natural language processing, genetic algorithms, and beyond - in expediting healthcare PPM, this research offers a fresh viewpoint. We offer an extensive analysis outlining AI's capacity to manage the healthcare system's increasing complexity and budgetary limitations, arguing in favor of an AI-enhanced approach to project selection, management, and outcome alignment with organizational goals. Our study highlights the role of AI in facilitating data-driven decision-making, operational effectiveness, and risk management. These factors allow for better patient care and increase organizational performance. However, it also recognizes the difficulties that AI integration presents, such as worries about algorithmic transparency, data privacy, and ethical ramifications. As a future step, the report suggests creating advanced AI tools with ethical foundations that are specifically designed to meet the needs of the healthcare industry. This study lays forth a future in which PPM and AI are combined to create a more strategic, effective, and patient-focused field for healthcare project management.
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Canaud, Bernard. "Mechanisms Supporting the Clinical Benefits of Hemodiafiltration: A Comprehensive Review." In 7th International Congress of Cardionephrology KARNEF 2025. Punta Niš, 2025. https://doi.org/10.46793/karnef25.144c.
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Background: Online hemodiafiltration (OHDF) is an advanced kidney replacement therapy (KRT) that enhances uremic toxin clearance and offers cardiovascular benefits over conventional high-flux hemodialysis (HD), provided that high convective volumes are achieved. Objective: This review examines the mechanisms underlying OHDF’s clinical and benefits and how they contribute to improve patient outcomes. Key Findings: OHDF improves vascular and cardiac health by stabilizing hemodynamics, reducing inflammation and oxidative stress, and enhancing middle- and large-molecular-weight toxin removal. Additional benefits include better anemia management, improved nutritional status, and enhanced quality of life. Future Directions: Research should explore patient-centered kidney care, effects on subgroup of patients such as diabetic, cardiac or elderly, and its potential role in incremental and intensive dialysis. Conclusion: OHDF is a superior dialysis modality that improves survival and patient outcomes, primarily by improving vascular and cardiac health. These benefits underscore the need for broader adoption and patient-centered optimization of OHDF.
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Sun, Rachel, and Yujia Zhang. "A Comprehensive Mobile Application to Monitor and Enhance Kidney Health for Dialysis Patients using Machine Learning." In 5th International Conference on Networks, Blockchain and Internet of Things. Academy & Industry Research Collaboration Center, 2024. http://dx.doi.org/10.5121/csit.2024.1405113.
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In the evolving landscape of healthcare, timely and accurate medical predictions are paramount, especially in managing chronic conditions like kidney disease. This paper introduces an innovative AI-driven application designed to enhance renal health management by predicting the need for dialysis and anemia, critical aspects of kidney care. Utilizing advanced algorithms such as Support Vector Machine (SVM) and XGBoost, coupled with cross-validation techniques, the application aims to provide reliable health predictions based on patient data. Challenges including model accuracy and processing speed were meticulously addressed through algorithm optimization and efficient data handling, ensuring the system's responsiveness to varying data complexities. Experimentation with mock patient scenarios revealed the system's capability to deliver precise anemia predictions and identify dialysis needs promptly, highlighting its potential in clinical settings. The application's blend of accuracy, speed, and user-centric design positions it as a valuable tool for patients and healthcare providers, promising to improve outcomes and decision-making in kidney health management.
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Ghidotti, Anna, Daniele Regazzoni, and Miri Weiss Cohen. "Bi-Level 3D Reconstruction of Malignant Pleural Mesothelioma Volume From CT Images." In ASME 2023 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2023. http://dx.doi.org/10.1115/imece2023-112558.
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Abstract This paper introduces an assistive system for diagnosing malignant pleural mesothelioma (MPM), a highly aggressive cancer caused by asbestos exposure. The system assists healthcare providers in accurately determining the tumor’s volume and the appropriate dose of chemotherapy to administer. It employs a bi-level process that uses machine learning and deep learning techniques to classify CT images of lungs and then calculate the tumor’s volume. The study addresses the challenges associated with deep nets, such as the need for large and diverse datasets, hyperparameter optimization, and potential data bias. Two CNN architectures, Inception-v3 and ResNet-50, were compared in terms of their features and performance, and three hyperparameters were optimized for each model to generate a broad range of training scenarios. To estimate the amount of cancer cells to target, CT images were used to calculate the tumor’s volume. This process involved image pre-processing, cropping volume, registering and filtering images, filling holes, segmentation, and 3D reconstruction. The results demonstrate that the developed system utilizing CNN optimizations and reconstruction of 3D images from CT images can benefit the treatment of MPM patients. The system has the potential to improve the accuracy of MPM diagnosis and the effectiveness of chemotherapy, ultimately improving patient outcomes.
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Pourshams, Mohammad, Timothee Cullaz, Pete Angelo Rocco, Behrang Poorganji, and Mohammad Elahinia. "Enhancing NiTi Implants through Binder Jetting: Microstructure, Impurity Control, and Post-processing Optimization." In SMST 2024. ASM International, 2024. http://dx.doi.org/10.31399/asm.cp.smst2024p0016.
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Abstract Additive manufacturing (AM), also known as 3D printing, has created new possibilities for designing and producing innovative NiTi medical implants. This technology offers significant advantages over traditional manufacturing methods, including the ability to produce complex geometries tailored to individual patient anatomy, potentially leading to better surgical outcomes and faster recovery times. These capabilities facilitate the creation of implants that are not only more biocompatible but also capable of promoting better osseointegration and reducing the risk of implant rejection.
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Perilli, Valter, Paola Aceto, Andrea Russo, et al. "Impact on outcome and healthcare costs from hemodynamic optimization in patients undergoing pancreatic surgery: a preliminary report." In 2018 IEEE International Symposium on Medical Measurements and Applications (MeMeA). IEEE, 2018. http://dx.doi.org/10.1109/memea.2018.8438724.
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Jalali, Ali, Robert A. Berg, Vinay M. Nadkarni, and C. Nataraj. "Improving Cardiopulmonary Resuscitation (CPR) by Dynamic Variation of CPR Parameters." In ASME 2013 Dynamic Systems and Control Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/dscc2013-3879.
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Cardiopulmonary resuscitation (CPR) is a commonly used procedure and plays a critical role in saving the lives of patients suffering from cardiac arrest. This paper is concerned with the design of a dynamic technique to optimize the performance of CPR and to consequently improve its outcome, the survival rate. Current American Heart Association (AHA) guidelines treat CPR as a static procedure with fixed parameters. These guidelines set fixed values for CPR parameters such as compression to ventilation ratio, chest compression depth, etc., with an implicit assumption that they are somehow “optimal,” which has not been really substantiated. In this study, in a quest to improve this oft-used procedure, an interactive technique has been developed for dynamically changing the CPR parameters. Total blood gas delivery which is combination of systemic oxygen delivery and carbon dioxide delivery to the lungs has been defined as the objective function, and a sequential optimization procedure has been explored to optimize the objective function by dynamically adjusting the CPR parameters. The results of comparison between the sequential optimization procedure and the global optimization procedure show that the sequential optimization procedure could significantly enhance the effectiveness of CPR.
Reports on the topic "Patient Outcome Optimization"
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Tang, Jiqin, Gong Zhang, Jinxiao Xing, Ying Yu, and Tao Han. Network Meta-analysis of Heat-clearing and Detoxifying Oral Liquid of Chinese Medicines in Treatment of Children’s Hand-foot-mouth Disease：a protocol for systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2022. http://dx.doi.org/10.37766/inplasy2022.1.0032.
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Review question / Objective: The type of study was clinical randomized controlled trial (RCT). The object of study is the patients with HFMD. There is no limit to gender and race. In the case of clear diagnosis standard, curative effect judgment standard and consistent baseline treatment, the experimental group was treated with pure oral liquid of traditional Chinese medicine(A: Fuganlin oral liquid, B: huangzhihua oral liquid, C: Lanqin oral liquid, D: antiviral oral liquid, E: Huangqin oral liquid, F: Pudilan oral liquid, G: Shuanghuanglian oral liquid.)and the control group was treated with ribavirin or any oral liquid of traditional Chinese medicine. The data were extracted by two researchers independently, cross checked and reviewed according to the pre-determined tables. The data extraction content is (1) Basic information (including the first author, published journal and year, research topic). (2) Relevant information (including number of cases, total number of cases, gender, age, intervention measures, course of treatment of the experimental group and the control group in the literature). (3) Design type and quality evaluation information of the included literature. (4) Outcome measures (effective rate, healing time of oral ulcer, regression time of hand and foot rash, regression time of fever, adverse reactions.). The seven traditional Chinese medicine oral liquids are comparable in clinical practice, but their actual clinical efficacy is lack of evidence-based basis. Therefore, the purpose of this study is to use the network meta-analysis method to integrate the clinical relevant evidence of direct and indirect comparative relationship, to make quantitative comprehensive statistical analysis and sequencing of different oral liquid of traditional Chinese medicine with the same evidence body for the treatment of the disease, and then to explore the advantages and disadvantages of the efficacy and safety of different oral liquid of traditional Chinese medicine to get the best treatment plan, so as to provide reference value and evidence-based medicine evidence for clinical optimization of drug selection. Condition being studied: Hand foot mouth disease (HFMD) is a common infectious disease in pediatrics caused by a variety of enteroviruses. Its clinical manifestations are mainly characterized by persistent fever, hand foot rash, oral herpes, ulcers, etc. Because it is often found in preschool children, its immune system development is not perfect, so it is very vulnerable to infection by pathogens and epidemic diseases, resulting in rapid progress of the disease. A few patients will also have neurogenic pulmonary edema Meningitis, myocarditis and other serious complications even lead to death, so effectively improve the cure rate, shorten the course of disease, prevent the deterioration of the disease as the focus of the study. In recent years, traditional Chinese medicine has played an important role in the research of antiviral treatment. Many clinical practices have confirmed that oral liquid of traditional Chinese medicine can effectively play the role of antiviral and improve the body's immunity.