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Browsing by Author "Xu, Huiping"
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Item A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms(Oxford University Press, 2022) Gupta, Agrayan K.; Kasthurirathne, Suranga N.; Xu, Huiping; Li, Xiaochun; Ruppert, Matthew M.; Harle, Christopher A.; Grannis, Shaun J.; Medicine, School of MedicineHealthcare systems are hampered by incomplete and fragmented patient health records. Record linkage is widely accepted as a solution to improve the quality and completeness of patient records. However, there does not exist a systematic approach for manually reviewing patient records to create gold standard record linkage data sets. We propose a robust framework for creating and evaluating manually reviewed gold standard data sets for measuring the performance of patient matching algorithms. Our 8-point approach covers data preprocessing, blocking, record adjudication, linkage evaluation, and reviewer characteristics. This framework can help record linkage method developers provide necessary transparency when creating and validating gold standard reference matching data sets. In turn, this transparency will support both the internal and external validity of recording linkage studies and improve the robustness of new record linkage strategies.Item A simple two-step procedure using the Fellegi-Sunter model for frequency-based record linkage(Taylor & Francis, 2021-05-04) Xu, Huiping; Li, Xiaochun; Grannis, Shaun; Biostatistics, School of Public HealthThe widely used Fellegi-Sunter model for probabilistic record linkage does not leverage information contained in field values and consequently leads to identical classification of match status regardless of whether records agree on rare or common values. Since agreement on rare values is less likely to occur by chance than agreement on common values, records agreeing on rare values are more likely to be matches. Existing frequency-based methods typically rely on knowledge of error probabilities associated with field values and frequencies of agreed field values among matches, often derived using prior studies or training data. When such information is unavailable, applications of these methods are challenging. In this paper, we propose a simple two-step procedure for frequency-based matching using the Fellegi-Sunter framework to overcome these challenges. Matching weights are adjusted based on frequency distributions of the agreed field values among matches and non-matches, estimated by the Fellegi-Sunter model without relying on prior studies or training data. Through a real-world application and simulation, our method is found to produce comparable or better performance than the unadjusted method. Furthermore, frequency-based matching provides greater improvement in matching accuracy when using poorly discriminating fields with diminished benefit as the discriminating power of matching fields increases.Item Affective Properties of Mothers' Speech to Infants With Hearing Impairment and Cochlear Implants(American Speech-Language-Hearing Association, 2015-06) Kondaurova, Maria V.; Bergeson, Tonya R.; Xu, Huiping; Kitamura, Christine; Department of Otolaryngology--Head and Neck Surgery, IU School of MedicinePURPOSE: The affective properties of infant-directed speech influence the attention of infants with normal hearing to speech sounds. This study explored the affective quality of maternal speech to infants with hearing impairment (HI) during the 1st year after cochlear implantation as compared to speech to infants with normal hearing. METHOD: Mothers of infants with HI and mothers of infants with normal hearing matched by age (NH-AM) or hearing experience (NH-EM) were recorded playing with their infants during 3 sessions over a 12-month period. Speech samples of 25 s were low-pass filtered, leaving intonation but not speech information intact. Sixty adults rated the stimuli along 5 scales: positive/negative affect and intention to express affection, to encourage attention, to comfort/soothe, and to direct behavior. RESULTS: Low-pass filtered speech to HI and NH-EM groups was rated as more positive, affective, and comforting compared with the such speech to the NH-AM group. Speech to infants with HI and with NH-AM was rated as more directive than speech to the NH-EM group. Mothers decreased affective qualities in speech to all infants but increased directive qualities in speech to infants with NH-EM over time. CONCLUSIONS: Mothers fine-tune communicative intent in speech to their infant's developmental stage. They adjust affective qualities to infants' hearing experience rather than to chronological age but adjust directive qualities of speech to the chronological age of their infants.Item Associations of chronic diarrhoea with non-alcoholic fatty liver disease and obesity-related disorders among US adults(BMJ, 2019-08-12) Shin, Andrea; Xu, Huiping; Imperiale, Thomas F.; Medicine, School of MedicineMechanisms explaining observed associations between diarrhoea and obesity or increased body mass index (BMI) are unclear. Objective: To assess associations of bowel patterns with BMI, metabolic syndrome (MS), non-alcoholic fatty liver disease (NAFLD) and other obesity-related disorders. Design: We performed a cross-sectional analysis of data from adults who completed bowel health questions for the 2005 to 2010 cycles of the National Health and Nutrition Examination Surveys. Relationships were examined using multinomial logistic regression. Confounding effects of demographics, smoking, alcohol and BMI were examined by sequential modelling. Results: Among 13 413 adults, weighted prevalence rates of constipation and diarrhoea were 8.9% and 6.6%, respectively. Mean BMI was associated with bowel patterns (p<0.001), and was higher with diarrhoea (30.3 kg/m2) versus normal bowel patterns (28.6 kg/m2) and with diarrhoea versus constipation (27.8 kg/m2). NAFLD was more prevalent (ORs, 95% CI) in diarrhoea versus normal bowel patterns (OR=1.34, 95% CI 1.01 to 1.78) or constipation (OR=1.45, 95% CI 1.03, 2.03) in adjusted analyses. The higher prevalence of MS in diarrhoea versus constipation (OR=1.27, 95% CI 0.97 to 1.67) was not independent of BMI. Conclusions: These findings suggest an association between diarrhoea and NAFLD that is independent of BMI.Item Associations of Fecal Short Chain Fatty Acids With Colonic Transit, Fecal Bile Acid, and Food Intake in Irritable Bowel Syndrome(Wolters Kluwer, 2023-01-01) Waseem, Mohammed Ray; Shin, Andrea; Siwiec, Robert; James-Stevenson, Toyia; Bohm, Matthew; Rogers, Nicholas; Wo, John; Waseem, Lina; Gupta, Anita; Jarrett, Megan; Kadariya, Jhalka; Xu, Huiping; Medicine, School of MedicineIntroduction: Short-chain fatty acids (SCFAs) correlate with colonic transit time (CTT) and may influence irritable bowel syndrome (IBS) pathophysiology. However, the clinical significance of fecal SCFAs, relationships between SCFAs and other metabolites (bile acids [BAs]), and real-time diet effects on SCFAs in IBS are uncertain. The aim was to evaluate fecal SCFA associations with IBS phenotype and mechanisms and explore effects of real-time diet. Methods: We conducted a prospective observational study of fecal SCFA, BAs, and CTT in healthy controls (HCs) and participants with IBS. We compared study end points across groups, analyzed relationships between end points, and evaluated the discriminative ability of SCFAs. Diet effects were explored in participants with dietary data. Results: Among 21 HCs and 43 participants with IBS, fecal SCFAs (total, individual) were inversely correlated with overall (all P < 0.01) and segmental (all P < 0.05) CTT; similar associations were observed within HC and IBS groups. The acetate-to-butyrate ratio correlated with slower overall and left CTT in all and in HCs (both P < 0.01). SCFAs (total, acetate) correlated with BAs (total, % primary) in all participants and in those with IBS with diarrhea. Logistic regression analyses demonstrated associations of acetate with slower transit (odds ratio = 0.988, P = 0.002) and BA diarrhea (BAD; odds ratio = 1.014, P = 0.001). Acetate accurately predicted delayed CTT (area under the receiving operating characteristic curve = 0.84) and BAD (area under the receiver operating characteristic curve = 0.79). Adjusting for diet strengthened correlations of total SCFAs with overall CTT ( R = [-0.46], P = 0.04) and SCFAs with transverse CTT (all P < 0.05). Discussion: Fecal SCFAs correlate with CTT and fecal BAs and reliably exclude delayed CTT and BAD. Accounting for diet strengthens SCFA associations with transit.Item Associations of Food Intolerance with Irritable Bowel Syndrome, Psychological Symptoms, and Quality of Life(Elsevier, 2022) Jansson-Knodell, Claire L.; White, Mattie; Lockett, Carolyn; Xu, Huiping; Shin, Andrea; Medicine, School of MedicineBackground & aims: The impact of different types of food intolerance on gastrointestinal symptoms and quality of life (QOL) is poorly understood. We aimed to investigate associations of food intolerance and type of intolerance with irritable bowel syndrome (IBS), health-related QOL, and psychological symptoms. Methods: We conducted an observational study of United States-based adults through an online survey. Demographics, culprit foods, symptoms, medical evaluation, Rome IV criteria for IBS, health-related QOL (Short-Form Health Survey 12), and anxiety and depression scores (Hospital Anxiety and Depression Scale) were collected in participants with self-reported food intolerance (lactose, non-lactose food, lactose plus food intolerance), and controls with no intolerance. Univariable associations of group with study endpoints were analyzed with the Kruskal-Wallis and Pearson χ2 or Fisher exact test. Multivariable comparisons were analyzed by logistic and linear regression. Results: A total of 197 patients with (59 lactose, 61 non-lactose food, 77 lactose plus food intolerance) and 273 patients without intolerance participated. Lactose, wheat, and eggs were the most common food triggers. Gas (54.2%), abdominal pain (40.2%), and diarrhea (37.3%) were frequently reported symptoms of food intolerance. Reactions caused 57.8% to eliminate the food. Rates of IBS, abnormal anxiety scores, and abnormal depression scores were highest in lactose plus food intolerance; Short-Form Health Survey 12 scores were lowest in lactose plus food intolerance. Multivariable analyses revealed all intolerance subgroups were more likely to have IBS than controls. Conclusions: Food intolerance is associated with IBS, anxiety, depression, and decreased health-related QOL and frequently leads to food elimination. Adults with lactose and lactose plus food intolerance have higher rates of IBS, increased psychological symptoms, and poorer QOL.Item Associations of Habitual Dietary Intake With Fecal Short-Chain Fatty Acids and Bowel Functions in Irritable Bowel Syndrome(Wolters Kluwer, 2022) Calderon, Gerardo; Patel, Chirag; Camilleri, Michael; James-Stevenson, Toyia; Bohm, Matthew; Siwiec, Robert; Rogers, Nicholas; Wo, John; Lockett, Carolyn; Gupta, Anita; Xu, Huiping; Shin, Andrea; Medicine, School of MedicineBackground goals: Diet may contribute to symptoms of irritable bowel syndrome (IBS) and luminal production of putative IBS biomarkers including short-chain fatty acids (SCFAs). Study aims were to to assess relationships of habitual fiber or starch intake with fecal SCFAs in patients with IBS and healthy volunteers (HVs). Study: In 18 HVs and 30 patients with IBS (13 constipation-predominant [IBS-C] and 17 diarrhea-predominant [IBS-D]), habitual diet using a food frequency questionnaire; bowel functions using a validated bowel diary; and fecal SCFAs by HPLC-mass spectrometry were assessed. Associations of fiber and starch with SCFAs were analyzed using Spearman (rs) and Pearson (R) correlations. Relationships between other dietary endpoints, SCFAs, and bowel functions were explored. Results: Habitual fiber or starch intakes were not significantly correlated with SCFAs or bowel functions in all participants or HVs nor with SCFAs in IBS. Starch was negatively correlated (R=-0.53; P=0.04) with complete evacuation in IBS-D. Fiber (rs=0.65; P=0.02) and starch (rs=0.56; P=0.05) were correlated with ease of passage in IBS-C. Stool form, frequency, and ease of passage were positively correlated with total SCFAs (all P<0.05), acetate (all P<0.01), propionate (all P<0.05), and butyrate (form P=0.01; ease of passage P=0.05) among all participants, but not in IBS. Complete evacuation was negatively correlated with propionate (R=-0.34; P=0.04) in all participants. Total (P=0.04) and individual SCFAs (all P<0.05) were positively correlated with stool form in HVs. Conclusions: Habitual fiber and starch intake does not influence fecal SCFAs but may influence bowel functions in IBS. Fecal SCFAs correlate with bowel functions among all participants including HVs.Item Childhood Bully Victimization and Adverse Life Outcomes(2023-10) Adhikary, Satabdi; Tennekoon, Vidhura; Royalty, Anne; Morrison, Gwendolyn; Ottoni-Wilhelm, Mark; Xu, HuipingBullying is widely prevalent in the US. Although anti-bullying laws have been implemented across the country since 1999, bullying prevalence rates remain high. Research suggests that being a bully or a bully victim or both makes an individual more likely to experience worse physical, mental, and financial health. This dissertation comprises of three essays examining the adverse effects of bully victimization on life outcomes. The first essay examines, using Panel Study of Income Dynamics (PSID) data, how being a victim of bullying affects sleep hours of an individual over the years. Results suggest that being a bully victim during teenage years reduces sleep hours, both contemporaneously and during early adulthood. The second essay uses the National Longitudinal Survey of Youth 1997 (NLSY97) data to examine how repeated bully victimization experiences in childhood and teenage years affect future labor market outcomes. A standard Mincer wage equation is used in a Heckman selection model and Inverse Probability Weighting (IPW) model to derive the estimates. Results indicate that being repeatedly bullied in teenage years reduces future earnings, mainly through reduced wage rates. The third essay, using NLSY97, looks at the effect of repeated bully victimization on wealth accumulation during early adult ages in difference-in-difference type framework. Measures of wealth accumulation include net household worth and its components, financial and non-financial assets, and financial debt at 20, 25, 30 and 35 years of age. Results indicate that the bully victims accumulate fewer net assets during the ages 20-35 than their non-victimized counterparts.Item Comparison of Supervised Machine Learning and Probabilistic Approaches for Record Linkage(AMIA Informatics summit 2019 Conference Proceedings., 2020-03-25) McNutt, Andrew T.; Grannis, Shaun J.; Bo, Na; Xu, Huiping; Kasthurirathne, Suranga N.Record linkage is vital to prevent fragmentation of patient data. Machine learning approaches present considerable potential for record linkage. We compared the performance of three machine learning algorithms to an established probabilistic record linkage technique. Machine learning approaches exhibited results that were comparable, or statistically superior to the established probabilistic approach. It is unclear if the cost of manually reviewing datasets for supervised learning is justified by the performance improvements they yield.Item Delayed Gastric Emptying Is Not Associated with a Microbiological Diagnosis of Small Intestinal Bacterial Overgrowth(Springer, 2021) Calderon, Gerardo; Siwiec, Robert M.; Bohm, Matthew E.; Nowak, Thomas V.; Wo, John M.; Gupta, Anita; Xu, Huiping; Shin, Andrea; Medicine, School of MedicineBackground: Clinical symptoms of patients with small intestinal bacterial overgrowth (SIBO) may overlap with symptoms of gastroparesis. Prior studies suggest delayed small intestinal transit is associated with SIBO, but have not shown an association between delayed gastric emptying and SIBO. However, these studies have generally relied on the indirect method of breath testing to diagnose SIBO. Aims: The aim of this study was to examine the association between a microbiological diagnosis of SIBO and delayed gastric emptying by scintigraphy. Methods: In a single-center retrospective study of previous research participants who presented for small bowel enteroscopy for diagnostic evaluation of SIBO, we identified 73 participants who underwent gastric emptying study by scintigraphy. A microbiological diagnosis of SIBO was made in patients based on culture results of jejunal aspirates. Clinical symptoms were assessed using the total gastroparesis cardinal symptom index (GCSI) score. We compared delayed gastric emptying, 2- and 4-h gastric retention, and gastroparesis symptoms between patients with and without a microbiological diagnosis of SIBO. Key results: Among 29 participants with SIBO and 44 without SIBO, 33 (45%) had evidence of delayed gastric emptying. There was no significant association between a microbiological diagnosis of SIBO and delayed gastric emptying by scintigraphy. Percent retained at 2 and 4 h, and total GCSI scores did not differ significantly between those with and without SIBO. Conclusions: Although delayed gastric emptying is common in patients with suspected SIBO, gastric emptying is not associated with a microbiological diagnosis of SIBO.