scholarly journals Predicting the postoperative blood coagulation state of children with congenital heart disease by machine learning based on real-world data

2021 ◽  
Vol 10 (1) ◽  
pp. 33-43
Author(s):  
Kai Guo ◽  
Xiaoyan Fu ◽  
Huimin Zhang ◽  
Mengjian Wang ◽  
Songlin Hong ◽  
...  
Keyword(s):  
Machine Learning ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Blood Coagulation ◽  
Real World ◽  
Congenital Heart ◽  
Real World Data ◽  
World Data

scholarly journals Pulmonary Hypertension in Adults with Congenital Heart Disease: Real-World Data from the International COMPERA-CHD Registry

2020 ◽  
Vol 9 (5) ◽  
pp. 1456
Author(s):  
Harald Kaemmerer ◽  
Matthias Gorenflo ◽  
Dörte Huscher ◽  
David Pittrow ◽  
Christian Apitz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Combination Therapy ◽  
Real World ◽  
Congenital Heart ◽  
Real World Data ◽  
Number Of Patients

Introduction: Pulmonary hypertension (PH) is a common complication in patients with congenital heart disease (CHD), aggravating the natural, post-operative, or post-interventional course of the underlying anomaly. The various CHDs differ substantially in characteristics, functionality, and clinical outcomes among each other and compared with other diseases with pulmonary hypertension. Objective: To describe current management strategies and outcomes for adults with PH in relation to different types of CHD based on real-world data. Methods and results: COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension) is a prospective, international PH registry comprising, at the time of data analysis, >8200 patients with various forms of PH. Here, we analyzed a subgroup of 680 patients with PH due to CHD, who were included between 2007 and 2018 in 49 specialized centers for PH and/or CHD located in 11 European countries. At enrollment, the patients’ median age was 44 years (67% female), and patients had either pre-tricuspid shunts, post-tricuspid shunts, complex CHD, congenital left heart or aortic disease, or miscellaneous other types of CHD. Upon inclusion, targeted therapies for pulmonary arterial hypertension (PAH) included endothelin receptor antagonists, PDE-5 inhibitors, prostacyclin analogues, and soluble guanylate cyclase stimulators. Eighty patients with Eisenmenger syndrome were treatment-naïve. While at inclusion the primary PAH treatment for the cohort was monotherapy (70% of patients), with 30% of the patients on combination therapy, after a median observation time of 45.3 months, the number of patients on combination therapy had increased significantly, to 50%. The use of oral anticoagulants or antiplatelets was dependent on the underlying diagnosis or comorbidities. In the entire COMPERA-CHD cohort, after follow-up and receiving targeted PAH therapy (n = 511), 91 patients died over the course of a 5-year follow up. The 5-year Kaplan–Meier survival estimate for CHD associated PH was significantly better than that for idiopathic PAH (76% vs. 54%; p < 0.001). Within the CHD associated PH group, survival estimates differed particularly depending on the underlying diagnosis and treatment status. Conclusions: In COMPERA-CHD, the overall survival of patients with CHD associated PH was dependent on the underlying diagnosis and treatment status, but was significantly better as than that for idiopathic PAH. Nevertheless, overall survival of patients with PAH due to CHD was still markedly reduced compared with survival of patients with other types of CHD, despite an increasing number of patients on PAH-targeted combination therapy.

Invasive electrophysiological studies in adult congenital heart disease- evolving use and impact of specialized centre therapy on recurrence of arrhythmia: a nationwird analysis based on 2.433 cases

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.J Fischer ◽  
D Enders ◽  
H Baumgartner ◽  
G.P Diller
Keyword(s):  
Atrial Fibrillation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Real World ◽  
Congenital Heart ◽  
Complex Disease ◽  
Annual Number ◽  
Electrophysiological Studies ◽  
Supraventricular Tachycardias ◽  
The Impact

Abstract Background Arrhythmias are a major contributor to morbidity and mortality in adult patients with congenital heart disease (ACHD). Advances in ablation technology have contributed to improved management and reduction of symptoms in this population. However, only limited data exist on the use and outcome of these technologies in large community-based cohorts of ACHD patients and on the impact of specialized centres on recurrence of arrhythmias. Purpose We performed a retrospective analysis based on data from one of the largest German Health Insurance Companies (approx. 9 million insured members), acquiring real-world data on frequency of invasive electrophysiological studies (EPS) in Germany between 2005 and 2018. ACHD patients were identified based on ICD codes and the spectrum of disease as well as the impact of EPS being performed at specialized ACHD centres was analysed. Results Out of 45,761 eligible ACHD patients in the database, we identified 2,433 EPS performed in 1,706 ACHD (51% female, median age 55.4 years, complexity of CHD mild, moderate and severe in 50.6%, 33.2%,16.2%, respectively). Over the study period the annual number of EPS increased by 207%. The majority of procedures were for supraventricular tachycardias (85.9%). Of these procedures atrial fibrillation accounted for 35.1%, atrial flutter for 29.4% and other supraventricular tachycardias/pre-excitation syndromes for 29.9% of cases. The majority of EPS (64.3%) was performed at non-specialized centres including 40.2% of cases in patients with complex disease. Overall, the re- intervention rate within 12 months of the primary EPS was 14.5%. Whereas in ACHD patients with simple and moderate complexity disease no obvious difference in 12-months re- intervention rate was observed between specialized and non-specialised centres (15.5% vs. 15.0%), in patients with complex disease the reintervention rate was 41.6% higher for non-specialized centres (13.6% vs. 9.6%). Conclusion Our large real- world analysis shows an increasing need for invasive electrophysiological studies in ACHD patients. The vast majority of procedures was performed for supraventricular arrhythmias including in atrial fibrillation and flutter ablation. Re-interventions were frequently required in this unique and anatomically challenging population. Alarmingly, many procedures were performed at non-specialized centres, although current guidelines recommend that interventions in complex patients should remain reserved for experienced high-volume centres. Funding Acknowledgement Type of funding source: None

scholarly journals Developing a machine learning environmental allergy prediction model from real world data through a novel decentralized mobile study platform.

2020 ◽  
Author(s):  
Chethan Sarabu ◽  
Sandra Steyaert ◽  
Nirav Shah
Keyword(s):  
Machine Learning ◽  
Real World ◽  
Predictive Models ◽  
Clinical Care ◽  
Sensor Data ◽  
Real World Data ◽  
World Data ◽  
Demographic Groups ◽  
Prediction And Prevention ◽  
Wide Range

Environmental allergies cause significant morbidity across a wide range of demographic groups. This morbidity could be mitigated through individualized predictive models capable of guiding personalized preventive measures. We developed a predictive model by integrating smartphone sensor data with symptom diaries maintained by patients. The machine learning model was found to be highly predictive, with an accuracy of 0.801. Such models based on real-world data can guide clinical care for patients and providers, reduce the economic burden of uncontrolled allergies, and set the stage for subsequent research pursuing allergy prediction and prevention. Moreover, this study offers proof-of-principle regarding the feasibility of building clinically useful predictive models from 'messy,' participant derived real-world data.

scholarly journals An application of machine learning based on real-world data: Mining features of fibrinogen in clinical stages of lung cancer between sexes

2021 ◽  
Vol 9 (8) ◽  
pp. 623-623
Author(s):  
Fangtao Yin ◽  
Hongyu Zhu ◽  
Songlin Hong ◽  
Chen Sun ◽  
Jie Wang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Lung Cancer ◽  
Data Mining ◽  
Real World ◽  
Real World Data ◽  
World Data ◽  
Clinical Stages
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