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Studies in Health Technology and... Aug 2019Understanding the progression of chronic diseases, such as chronic obstructive pulmonary disease (COPD), is important to inform early diagnosis, personalized care, and...
Understanding the progression of chronic diseases, such as chronic obstructive pulmonary disease (COPD), is important to inform early diagnosis, personalized care, and health system management. Data from clinical and administrative systems have the potential to advance this understanding, but traditional methods for modelling disease progression are not well-suited to analyzing data collected at irregular intervals, such as when a patient interacts with a healthcare system. We applied a continuous-time hidden Markov model to irregularly-spaced healthcare utilization events and patient-level characteristics in order to analyze the progression through discrete states of 76,888 patients with COPD. A 4-state model allowed classification of patients into interpretable states of disease progression and generated insights about the role of comorbidities, such as cardiovascular diseases, in accelerating severe trajectories. These results can improve the understanding of the evolution of COPD and point to new hypotheses about chronic disease management and comorbidity.
Topics: Cardiovascular Diseases; Chronic Disease; Comorbidity; Disease Progression; Humans; Pulmonary Disease, Chronic Obstructive
PubMed: 31438058
DOI: 10.3233/SHTI190358 -
Journal of the American College of... Nov 2019
Topics: Aortic Valve Insufficiency; Disease Progression; Humans; Reoperation
PubMed: 31727287
DOI: 10.1016/j.jacc.2019.08.1059 -
Nutrition and Health Mar 2023It has been suggested that the lowering of dietary protein reduces the progression of CKD, despite it has been also reported that higher intake of total protein was...
It has been suggested that the lowering of dietary protein reduces the progression of CKD, despite it has been also reported that higher intake of total protein was associated with a lower risk of cardiovascular morbidity.The role of protein intake is equivocal in clinical outcomes including the renal and cardiovascular disease worsening, metabolic acidosis and bone abnormalities.The modification of both amount and sources of protein intake could influence the renal and cardiovascular deterioration.
Topics: Humans; Renal Insufficiency, Chronic; Disease Progression; Cardiovascular Diseases
PubMed: 35946110
DOI: 10.1177/02601060221118897 -
Journal of the American Society of... Nov 2002
Review
Topics: Disease Progression; Humans; Kidney Diseases; Sex Characteristics
PubMed: 12397053
DOI: 10.1097/01.asn.0000035846.89753.d4 -
European Urology Jun 2006
Review
Topics: Disease Progression; Humans; Male; Penile Induration
PubMed: 16530929
DOI: 10.1016/j.eururo.2006.02.048 -
American Journal of Nephrology 2022
Topics: Disease Progression; Glomerular Filtration Rate; Humans; Kidney; Kidney Diseases
PubMed: 35691290
DOI: 10.1159/000524890 -
Frontiers in Public Health 2022Depression is a common mental health condition that affects millions of people worldwide. Care pathways for depression are complex and the demand across different parts...
INTRODUCTION
Depression is a common mental health condition that affects millions of people worldwide. Care pathways for depression are complex and the demand across different parts of the healthcare system is often uncertain and not entirely understood. Clinical progression with depression can be equally complex and relates to whether or not a patient is seeking care, the care pathway they are on, and the ability for timely access to healthcare services. Considering both pathways and progression for depression are however rarely studied together in the literature.
METHODS
This paper presents a hybrid simulation modeling framework that is uniquely able to capture both disease progression, using Agent Based Modeling, and related care pathways, using a System Dynamics. The two simulation paradigms within the framework are connected to run synchronously to investigate the impact of depression progression on healthcare services and, conversely, how any limitations in access to services may impact clinical progression. The use of the developed framework is illustrated by parametrising it with published clinical data and local service level data from Wales, UK.
RESULTS AND DISCUSSION
The framework is able to quantify demand, service capacities and costs across all care pathways for a range of different scenarios. These include those for varying service coverage and provision, such as the cost-effectiveness of treating patients more quickly in community settings to reduce patient progression to more severe states of depression, and thus reducing the costs and utilization of more expensive specialist settings.
Topics: Humans; Depression; Mental Disorders; Delivery of Health Care; Systems Analysis; Disease Progression
PubMed: 36817182
DOI: 10.3389/fpubh.2022.1011104 -
Brain : a Journal of Neurology May 2018This scientific commentary refers to ‘Data-driven models of dominantly-inherited Alzheimer’s disease progression’, by Oxtoby (doi:10.1093/brain/awy050).
This scientific commentary refers to ‘Data-driven models of dominantly-inherited Alzheimer’s disease progression’, by Oxtoby (doi:10.1093/brain/awy050).
Topics: Alzheimer Disease; Disease Progression; Humans
PubMed: 29701790
DOI: 10.1093/brain/awy089 -
Methods in Molecular Biology (Clifton,... 2023Fundus autofluorescence (FAF) imaging is a noninvasive retinal imaging methodology that allows mapping of lipofuscin distribution in the retinal pigment epithelium cell...
Fundus autofluorescence (FAF) imaging is a noninvasive retinal imaging methodology that allows mapping of lipofuscin distribution in the retinal pigment epithelium cell (RPE). Excessive accumulation of lipofuscin granules in the lysosomal compartment of RPE cells represents a common downstream pathogenetic pathway in various hereditary and complex retinal diseases, including age-related macular degeneration. The clinical applications of FAF coupled with its ease of use, and the noninvasive nature of characterizing retinal diseases, are increasingly valuable to the field of ophthalmology and in assessing the progression of retinitis pigmentosa (RP). Quantitative AF (qAF) enhances the understanding of retinal disease processes, serves as a diagnostic aid, and allows for the monitoring of the effects of therapeutic interventions. This chapter introduces basic principles of FAF and general protocols of FAF evaluating retinal disease progression in rodents.
Topics: Animals; Rodentia; Retinal Diseases; Optical Imaging; Disease Progression
PubMed: 36481899
DOI: 10.1007/978-1-0716-2651-1_21 -
JAMA Ophthalmology Sep 2023
Topics: Humans; Tomography, Optical Coherence; Disease Progression
PubMed: 37589988
DOI: 10.1001/jamaophthalmol.2023.3732