Browsing by Subject "Reproducibility of results"

Now showing 1 - 8 of 8
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    A comparison between perceived rurality and established geographic rural status among Indiana residents
    (Wolters Kluwer, 2023) Bhattacharyya, Oindrila; Rawl, Susan M.; Dickinson, Stephanie L.; Haggstrom, David A.; Economics, School of Liberal Arts
    The study assessed the association and concordance of the traditional geography-based Rural-Urban Commuting Area (RUCA) codes to individuals' self-reported rural status per a survey scale. The study included residents from rural and urban Indiana, seen at least once in a statewide health system in the past 12 months. Surveyed self-reported rural status of individuals obtained was measured using 6 items with a 7-point Likert scale. Cronbach's alpha was used to measure the internal consistency between the 6 survey response items, along with exploratory factor analysis to evaluate their construct validity. Perceived rurality was compared with RUCA categorization, which was mapped to residential zip codes. Association and concordance between the 2 measures were calculated using Spearman's rank correlation coefficient and Gwet's Agreement Coefficient (Gwet's AC), respectively. Primary self-reported data were obtained through a cross-sectional, statewide, mail-based survey, administered from January 2018 through February 2018, among a random sample of 7979 individuals aged 18 to 75, stratified by rural status and race. All 970 patients who completed the survey answered questions regarding their perceived rurality. Cronbach's alpha value of 0.907 was obtained indicating high internal consistency among the 6 self-perceived rurality items. Association of RUCA categorization and self-reported geographic status was moderate, ranging from 0.28 to 0.41. Gwet's AC ranged from -0.11 to 0.26, indicating poor to fair agreement between the 2 measures based on the benchmark scale of reliability. Geography-based and self-report methods are complementary in assessing rurality. Individuals living in areas of relatively high population density may still self-identify as rural, or individuals with long commutes may self-identify as urban.
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    Automated pancreatic cyst screening using natural language processing: a new tool in the early detection of pancreatic cancer
    (Elsevier, 2015-05) Roch, Alexandra M.; Mehrabi, Saeed; Krishnan, Anand; Schmidt, Heidi E.; Kesterson, Joseph; Beesley, Chris; Dexter, Paul R.; Palakal, Matthew; Schmidt, C. Max; Department of Surgery, IU School of Medicine
    INTRODUCTION: As many as 3% of computed tomography (CT) scans detect pancreatic cysts. Because pancreatic cysts are incidental, ubiquitous and poorly understood, follow-up is often not performed. Pancreatic cysts may have a significant malignant potential and their identification represents a 'window of opportunity' for the early detection of pancreatic cancer. The purpose of this study was to implement an automated Natural Language Processing (NLP)-based pancreatic cyst identification system. METHOD: A multidisciplinary team was assembled. NLP-based identification algorithms were developed based on key words commonly used by physicians to describe pancreatic cysts and programmed for automated search of electronic medical records. A pilot study was conducted prospectively in a single institution. RESULTS: From March to September 2013, 566,233 reports belonging to 50,669 patients were analysed. The mean number of patients reported with a pancreatic cyst was 88/month (range 78-98). The mean sensitivity and specificity were 99.9% and 98.8%, respectively. CONCLUSION: NLP is an effective tool to automatically identify patients with pancreatic cysts based on electronic medical records (EMR). This highly accurate system can help capture patients 'at-risk' of pancreatic cancer in a registry.
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    Deriving a Measure of Social Recovery Capital From the Important People and Activities Instrument: Construction and Psychometric Properties
    (Oxford University Press, 2022) Francis, Meredith W.; Bourdon, Jessica L.; Chan, Grace; Dick, Danielle M.; Edenberg, Howard J.; Kamarajan, Chella; Kinreich, Sivan; Kramer, John; Kuo, Sally I-Chun; Pandey, Ashwini K.; Pandey, Gayathri; Smith, Rebecca L.; Bucholz, Kathleen K.; McCutcheon, Vivia V.; Psychiatry, School of Medicine
    Aim: This study presents a measure of Social Recovery Capital (SRC) derived from the Important People and Activities instrument (IPA). Methods: The sample comprised young adults who participated in the Collaborative Study on the Genetics of Alcoholism, a high-risk family study of alcohol use disorder (N = 2472). Exploratory and confirmatory factor analysis identified influential items and factor structure, adjusting for family relatedness. The final scale was tested for reliability and validity. Results: Factor analysis retained 10 items loading on three factors (Network Abstinence Behaviors, Basic Network Structure and Network Importance) that together explained 42% of the variance in SRC. The total model showed adequate fit (Comparative Fit Index = 0.95; Tucker Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Squared Residual = 0.05) and acceptable reliability (α = 0.60; McDonald's ω = 0.73) and correlated with validation measures mostly in the weak to moderate range. Due to variable factor scores for reliability and validity, we only recommend using the total score. Conclusion: The SRC-IPA is a novel measure of SRC derived from the IPA that captures social network data and has applications in research and clinical work. Secondary data analyses using the SRC-IPA in studies that collected the IPA can further demonstrate the interaction of SRC with a wide variety of clinical indicators and demographic characteristics, making it a valuable addition to other measures of SRC.
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    Development and initial validation of an instrument for video-based assessment of technical skill in ERCP
    (Elsevier, 2021) Elmunzer, B. Joseph; Walsh, Catharine M.; Guiton, Gretchen; Serrano, Jose; Chak, Amitabh; Edmundowicz, Steven; Kwon, Richard S.; Mullady, Daniel; Papachristou, Georgios I.; Elta, Grace; Baron, Todd H.; Yachimski, Patrick; Fogel, Evan L.; Draganov, Peter V.; Taylor, Jason R.; Scheiman, James; Singh, Vikesh K.; Varadarajulu, Shyam; Willingham, Field F.; Cote, Gregory A.; Cotton, Peter B.; Simon, Violette; Spitzer, Rebecca; Keswani, Rajesh; Wani, Sachin; SVI study group; U.S. Cooperative for Outcomes Research in Endoscopy; Medicine, School of Medicine
    Background and aims: The accurate measurement of technical skill in ERCP is essential for endoscopic training, quality assurance, and coaching of this procedure. Hypothesizing that technical skill can be measured by analysis of ERCP videos, we aimed to develop and validate a video-based ERCP skill assessment tool. Methods: Based on review of procedural videos, the task of ERCP was deconstructed into its basic components by an expert panel that developed an initial version of the Bethesda ERCP Skill Assessment Tool (BESAT). Subsequently, 2 modified Delphi panels and 3 validation exercises were conducted with the goal of iteratively refining the tool. Fully crossed generalizability studies investigated the contributions of assessors, ERCP performance, and technical elements to reliability. Results: Twenty-nine technical elements were initially generated from task deconstruction. Ultimately, after iterative refinement, the tool comprised 6 technical elements and 11 subelements. The developmental process achieved consistent improvements in the performance characteristics of the tool with every iteration. For the most recent version of the tool, BESAT-v4, the generalizability coefficient (a reliability index) was .67. Most variance in BESAT scores (43.55%) was attributed to differences in endoscopists' skill, indicating that the tool can reliably differentiate between endoscopists based on video analysis. Conclusions: Video-based assessment of ERCP skill appears to be feasible with a novel instrument that demonstrates favorable validity evidence. Future steps include determining whether the tool can discriminate between endoscopists of varying experience levels and predict important outcomes in clinical practice.
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    Healthy Aging Brain Care Monitor Caregiver Version (HABC-M CG): An Informant-Based Screening Tool for Post-Intensive Care Syndrome (PICS)
    (American Association of Critical-Care Nurses, 2022) Wang, Sophia; Jawed, Yameena; Perkins, Anthony; Gao, Sujuan; Seyffert, Sarah; Khan, Sikandar; Boustani, Malaz; Khan, Babar; Psychiatry, School of Medicine
    Background: Cognitive impairment is common in intensive care unit survivors, pointing to the potential utility of a caregiver-based tool to screen for post-intensive care syndrome. Objective: To validate the Healthy Aging Brain Care Monitor, Caregiver Version (HABC-M CG), as a caregiver-based tool to screen for post-intensive care syndrome. Methods: A total of 116 patients who survived a stay in the intensive care unit completed standardized assessments of cognition, psychological symptoms, and physical functioning, and their caregivers completed the HABC-M CG. The Cronbach α was used to measure the internal consistency of the scale items. Validity of the HABC-M CG versus comparison tests was measured using the Spearman rank correlation. Generalized linear models were used to adjust for age, sex, and education level. Results: The total scale and all subscales of the HABC-M CG showed excellent internal consistency (Cronbach α = 0.88-0.93). Scores on the psychological subscale correlated with standardized measures of depressive symptoms (Spearman ρ = 0.58). Scores on the cognitive subscale correlated with the Mini-Mental State Examination score (Spearman ρ = -0.33). Scores on the functional subscale correlated with scores on the Physical Self-Maintenance Scale (Spearman ρ = -0.36). Conclusion: The HABC-M CG is a valid informant-based clinical tool for the assessment of symptoms of post- intensive care syndrome.
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    Increased spatial dimensions of repetitive heat and cold stimuli in older women
    (Wolters Kluwer, 2017-05) Naugle, Kelly M.; Cruz-Almeida, Yenisel; Fillingim, Roger B.; Staud, Roland; Riley, Joseph L., III; Kinesiology, School of Physical Education and Tourism Management
    Protocols of temporal summation (TS) of pain typically involve the delivery of brief repetitive noxious pulses of a constant intensity while measuring the perceived intensity of pain after each pulse. The size percept of noxious repetitive stimulation has been poorly characterized. Furthermore, no studies have investigated age differences in TS of cold pain. The current study examined TS of pain intensity and the perceived size of the painful area during repetitive noxious heat and cold pulses in healthy younger (n = 104) and older adults (n = 40). Trials of 10 brief repetitive noxious heat or cold pulses were delivered to the upper extremities. Participants rated the perceived size of the painful area or intensity of pain after each pulse. The magnitude of change for the size percept and intensity for pain were calculated for each trial. The results indicated that older adults experienced greater TS of the size percept of cold stimuli compared with younger adults. Additionally, older women experienced greater TS of the size percept of heat stimuli compared with older men and all younger participants. No overall age or sex differences were found in the TS of pain intensity for cold or heat trials. These results suggest dysfunctional modulation of the spatial percept of the painful stimuli by older adults, and in particular older women, during repetitive noxious thermal pulses.
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    Pediatric Drug-Associated Pancreatitis Reveals Concomitant Risk Factors and Poor Reliability of Causality Scoring: Report From INSPPIRE
    (Wiley, 2023) Morinville, Veronique D.; Husain, Sohail Z.; Wang, Fuchenchu; Cress, Gretchen A.; Abu-El-Haija, Maisam; Chugh, Ankur; Downs, Elissa; Ellery, Kate; Fishman, Douglas S.; Freeman, Alvin Jay; Gariepy, Cheryl E.; Giefer, Matthew; Gonska, Tanja; Liu, Quin; Maqbool, Asim; Mark, Jacob; Mcferron, Brian Arthur; Mehta, Megha; Nathan, Jaimie D.; Ng, Ken; Ooi, Chee Y.; Perito, Emily; Ruan, Wenly; Schwarzenberg, Sarah Jane; Sellers, Zachary M.; Serrano, Jose; Troendle, David M.; Wilschanski, Michael; Zheng, Yuhua; Yuan, Ying; Lowe, Mark; Uc, Aliye; Consortium for the Study of Chronic Pancreatitis, Diabetes and Pancreatic Cancer (CPDPC); Pediatrics, School of Medicine
    Objectives: Drug-associated acute pancreatitis (DAP) studies typically focus on single acute pancreatitis (AP) cases. We aimed to analyze the (1) characteristics, (2) co-risk factors, and (3) reliability of the Naranjo scoring system for DAP using INSPPIRE-2 (the INternational Study group of Pediatric Pancreatitis: In search for a cuRE-2) cohort study of acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) in children. Methods: Data were obtained from ARP group with ≥1 episode of DAP and CP group with medication exposure ± DAP. Physicians could report multiple risk factors. Pancreatitis associated with Medication (Med) (ARP+CP) was compared to Non-Medication cases, and ARP-Med vs CP-Med groups. Naranjo score was calculated for each DAP episode. Results: Of 726 children, 392 had ARP and 334 had CP; 51 children (39 ARP and 12 CP) had ≥1 AP associated with a medication; 61% had ≥1 AP without concurrent medication exposure. The Med group had other risk factors present (where tested): 10 of 35 (28.6%) genetic, 1 of 48 (2.1%) autoimmune pancreatitis, 13 of 51 (25.5%) immune-mediated conditions, 11 of 50 (22.0%) obstructive/anatomic, and 28 of 51 (54.9%) systemic risk factors. In Med group, 24 of 51 (47%) had involvement of >1 medication, simultaneously or over different AP episodes. There were 20 ARP and 4 CP cases in "probable" category and 19 ARP and 7 CP in "possible" category by Naranjo scores. Conclusions: Medications were involved in 51 of 726 (7%) of ARP or CP patients in INSPPIRE-2 cohort; other pancreatitis risk factors were present in most, suggesting a potential additive role of different risks. The Naranjo scoring system failed to identify any cases as "definitive," raising questions about its reliability for DAP.
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    Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study)
    (Wolters Kluwer, 2018-01) Mukhopadhyay, Sanjay; Feldman, Michael D.; Abels, Esther; Ashfaq, Raheela; Beltaifa, Senda; Cacciabeve, Nicolas G.; Cathro, Helen P.; Cheng, Liang; Cooper, Kumarasen; Dickey, Glenn E.; Gill, Ryan M.; Heaton, Robert P., Jr.; Kerstens, René; Lindberg, Guy M.; Malhotra, Reenu K.; Mandell, James W.; Manlucu, Ellen D.; Mills, Anne M.; Mills, Stacey E.; Moskaluk, Christopher A.; Nelis, Mischa; Patil, Deepa T.; Przybycin, Christopher G.; Reynolds, Jordan P.; Rubin, Brian P.; Saboorian, Mohammad H.; Salicru, Mauricio; Samols, Mark A.; Sturgis, Charles D.; Turner, Kevin O.; Wick, Mark R.; Yoon, Ji Y.; Zhao, Po; Taylor, Clive R.; Pathology and Laboratory Medicine, School of Medicine
    Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, -0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types.