5,729 research outputs found
InfoFair 2010- Kenneth D. Mandl, M.D., M.P.H. Lecture: "Patients at the Center of an Innovation Platform: Personally Controlled Health Records and the App Store for Health"
No full textKenneth D. Mandl, M.D., M.P.H. Presenting "Patients at the Center of an Innovation Platform: Personally Controlled Health Records and the App Store for Health." InfoFair 2010- "The Personal Health Record: Possible, Portable, Private?" Wednesday, December 1, 2010
Interview with Kenneth Sprunt
No full textKenneth Sprunt was born in Wilmington in 1920, the third son of James Lawrence Sprunt. The Sprunts have a long history in and around Wilimington. His grandfather was a cotton merchant in the area and his great-great Uncle is the man for whom James Sprunt Community College is named for as well as the author of Chronicles of the Lower Cape Fear. Mr. Kenneth Sprunt relates his family history both before his birth and after. He spent three years in the Coast Guard during WWII primarily working on anti-submarine warfare in small boats
Temporal Patterns of Medications Dispensed to Children and Adolescents in a National Insured Population
No full textThis study aimed to comprehensively describe prevalence and temporal dispensing patterns for medications prescribed to children and adolescents in the United States. Participants were 1.6 million children (49% female) under 18 years old enrolled in a nation-wide, employer-provided insurance plan. All medication claims from 1999–2006 were reviewed retrospectively. Drugs were assigned to 16 broad therapeutic categories. Effects of trend over time, seasonality, age and gender on overall and within category prevalence were examined. Results: Mean monthly prevalence for dispensed medications was 23.5% (range 19.4–27.5), with highest rates in winter and lowest in July. The age group with the highest prevalence was one-year-old children. On average each month, 17.1% of all children were dispensed a single drug and 6.4% were dispensed two or more. Over time, prevalence for two or more drugs did not change, but the proportion of children dispensed a single drug decreased (slope -.02%, p = .001). Overall, boys had higher monthly rates than girls (average difference 0.9%, p = .002). However, differences by gender were greatest during middle childhood, especially for respiratory and central nervous system agents. Contraceptives accounted for a large proportion of dispensed medication to older teenage girls. Rates for the drugs with the highest prevalence in this study were moderately correlated (average Pearson r.66) with those from a previously published national survey. Conclusion: On average, nearly one quarter of a population of insured children in the United States was dispensed medication each month. This rate decreased somewhat over time, primarily because proportionally fewer children were dispensed a single medication. The rate for two or more drugs dispensed simultaneously remained steady
Comparative Effectiveness Research: An Empirical Study of Trials Registered in ClinicalTrials.gov
No full textBackground
The $1.1 billion investment in comparative effectiveness research will reshape the evidence-base supporting decisions about treatment effectiveness, safety, and cost. Defining the current prevalence and characteristics of comparative effectiveness (CE) research will enable future assessments of the impact of this program.
Methods
We conducted an observational study of clinical trials addressing priority research topics defined by the Institute of Medicine and conducted in the US between 2007 and 2010. Trials were identified in ClinicalTrials.gov. Main outcome measures were the prevalence of comparative effectiveness research, nature of comparators selected, funding sources, and impact of these factors on results.
Results
231 (22.3%; 95% CI 19.8%–24.9%) studies were CE studies and 804 (77.7%; 95% CI, 75.1%–80.2%) were non-CE studies, with 379 (36.6%; 95% CI, 33.7%–39.6%) employing a placebo control and 425 (41.1%; 95% CI, 38.1%–44.1%) no control. The most common treatments examined in CE studies were drug interventions (37.2%), behavioral interventions (28.6%), and procedures (15.6%). Study findings were favorable for the experimental treatment in 34.8% of CE studies and greater than twice as many (78.6%) non-CE studies (P<0.001). CE studies were more likely to receive government funding (P = 0.003) and less likely to receive industry funding (P = 0.01), with 71.8% of CE studies primarily funded by a noncommercial source. The types of interventions studied differed based on funding source, with 95.4% of industry trials studying a drug or device. In addition, industry-funded CE studies were associated with the fewest pediatric subjects (P<0.001), the largest anticipated sample size (P<0.001), and the shortest study duration (P<0.001).
Conclusions
In this sample of studies examining high priority areas for CE research, less than a quarter are CE studies and the majority is supported by government and nonprofits. The low prevalence of CE research exists across CE studies with a broad array of interventions and characteristics.National Library of Medicine (U.S.) (5G08LM009778)National Institutes of Health (U.S.
Memorandum from Kenneth Iyeko
No full textMemorandum from Kenneth Iyeko regarding establishment and support of the Japanese American Citizens' League at incarceration camps operated by War Relocation Authority.Personal correspondence, organizational records, government documents, publications, and other papers created or collected by Joseph R. Goodman documenting the forced removal and incarceration of Japanese Americans during World War II, as well as organized resistance to incarceration. Included in the collection are records of the Japanese Young Men's Christian Association and the Japanese American Citizens' League in San Francisco, including papers of the Japanese YMCA's executive secretary Lincoln Kanai; Sakai family papers; Goodman's correspondence to and from Japanese American incarcerees, organizations opposing forced removal and incarceration of Japanese Americans, the War Relocation Authority, and others; publications, photographs, and ephemera from the Topaz Relocation Center, where Goodman taught high school; War Relocation Authority records and publications; and newspaper clippings, pamphlets, and reports about forced removal and incarceration created by various government, religious, and civic organizations, in California and nationwide
Premarket Safety and Efficacy Studies for ADHD Medications in Children
No full textBackground: Attention-deficit hyperactivity disorder (ADHD) is a chronic condition and pharmacotherapy is the mainstay of treatment, with a variety of ADHD medications available to patients. However, it is unclear to what extent the long-term safety and efficacy of ADHD drugs have been evaluated prior to their market authorization. We aimed to quantify the number of participants studied and their length of exposure in ADHD drug trials prior to marketing. Methods: We identified all ADHD medications approved by the Food and Drug Administration (FDA) and extracted data on clinical trials performed by the sponsor and used by the FDA to evaluate the drug’s clinical efficacy and safety. For each ADHD medication, we measured the total number of participants studied and the length of participant exposure and identified any FDA requests for post-marketing trials. Results: A total of 32 clinical trials were conducted for the approval of 20 ADHD drugs. The median number of participants studied per drug was 75 (IQR 0, 419). Eleven drugs (55%) were approved after <100 participants were studied and 14 (70%) after <300 participants. The median trial length prior to approval was 4 weeks (IQR 2, 9), with 5 (38%) drugs approved after participants were studied <4 weeks and 10 (77%) after <6 months. Six drugs were approved with requests for specific additional post-marketing trials, of which 2 were performed. Conclusions: Clinical trials conducted for the approval of many ADHD drugs have not been designed to assess rare adverse events or long-term safety and efficacy. While post-marketing studies can fill in some of the gaps, better assurance is needed that the proper trials are conducted either before or after a new medication is approved.Version of Recor
Longitudinal histories as predictors of future diagnoses of domestic abuse: modelling study
No full texthttp://www.bmj.com/content/339/bmj.b3677Objective To determine whether longitudinal data in
patients’ historical records, commonly available in
electronic health record systems, can be used to predict a
patient’s future risk of receiving a diagnosis of domestic
abuse.
Design Bayesian models, known as intelligent histories,
used to predict a patient’s risk of receiving a future
diagnosis of abuse, based on the patient’s diagnostic
history. Retrospective evaluation of the model’s
predictions using an independent testing set.
Setting A state-wide claims database covering six years of
inpatient admissions to hospital, admissions for
observation, and encounters in emergency departments.
Population All patients aged over 18 who had at least four
years between their earliest and latest visits recorded in
the database (561 216 patients).
Main outcome measures Timeliness of detection,
sensitivity, specificity, positive predictive values, and
area under the ROC curve.
Results 1.04% (5829) of the patients met the narrow case
definition for abuse, while 3.44% (19 303) met the
broader case definition for abuse. The model achieved
sensitive, specific (area under the ROC curve of 0.88), and
early (10-30 months in advance, on average) prediction of
patients’ future risk of receiving a diagnosis of abuse.
Analysis of model parameters showed important
differences between sexes in the risks associated with
certain diagnoses.
Conclusions Commonly available longitudinal diagnostic
data can be useful for predicting a patient’s future risk of
receiving a diagnosis of abuse. This modelling approach
could serve as the basis for an early warning system to
help doctors identify high risk patients for further
screening.National Library of Medicine (grants R01 LM009879, R01 LM007677, and G08LM009778)Centers for Disease Control and Prevention (U.S.) (grant R01 PH000040
A Review by Kenneth Atkinson of Alexandria and Qumran: Back to the Beginning, by Kenneth Silver
No full textKenneth Silver (a.k.a. Kenneth A. K. Lönnqvist), is a historian and professional archaeologist, who has lived and worked for decades in the Near East. With extensive publications on Hellenistic and Roman archaeology, history, and numismatics, Silver is the director of a survey and mapping project in Northern Mesopotamia studying the border zone between the late Roman/ Byzantine Empires and Persia. Author of numerous publications on Qumran and related topics, Silver’s lengthy monograph proposes that the documents and type of library found at Qumran were based on models derived from Egypt. The main thesis of the volume is that Pythagorean philosophy is the core and basis for the beliefs reflected in the non-Biblical texts found at Qumran
sj-docx-2-dhj-10.1177_20552076241249286 - Supplemental material for Explainable machine learning for predicting conversion to neurological disease: Results from 52,939 medical records
No full textSupplemental material, sj-docx-2-dhj-10.1177_20552076241249286 for Explainable machine learning for predicting conversion to neurological disease: Results from 52,939 medical records by Christina Felix, Joshua D Johnston, Kelsey Owen, Emil Shirima, Sidney R Hinds, Kenneth D Mandl, Alex Milinovich and Jay L Alberts in DIGITAL HEALTH</p
Patterning of chorion proteins in the drosophila eggshell
No full textM.S.Includes bibliographical referencesby Kenneth Ki
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