Abstract:
BACKGROUND AND AIMS:The Chronic Hepatitis Cohort Study (CHeCS) is a longitudinal observational study of risks and benefits of treatments and care in patients with chronic hepatitis B (HBV) and C (HCV) infection from four US health systems. We hypothesized that comparative effectiveness methods-including a centralized data management system and an adaptive approach for cohort selection-would improve cohort selection while controlling data quality and reducing the cost. METHODS:Cohort selection and data collection were performed primarily via the electronic health record (EHR); cases were confirmed via chart abstraction. Two parallel sources fed data to a centralized data management system: direct EHR data collection with common data elements, and chart abstraction via electronic data capture. An adaptive Classification and Regression Tree (CART) identified a set of electronic variables to improve case ascertainment accuracy. RESULTS:Over 16 million patient records were collected on 23 case report forms in 2006-2008. The vast majority of data (99.2%) were collected electronically from EHR; only 0.8% was collected via chart abstraction. Initial electronic criteria identified 12,144 chronic hepatitis patients; 10,098 were confirmed via chart abstraction with positive predictive values (PPV) 79 and 83% for HBV and HCV, respectively. CART-optimized models significantly increased PPV to 88 for HBV and 95% for HCV. CONCLUSIONS:CHeCS is a comparative effectiveness research project that leverages electronic centralized data collection and adaptive cohort identification approaches to enhance study efficiency. The adaptive CART model significantly improved the positive predictive value of cohort identification methods.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Lu M,Rupp LB,Moorman AC,Li J,Zhang T,Lamerato LE,Holmberg SD,Spradling PR,Teshale EH,Vijayadeva V,Boscarino JA,Schmidt MA,Nerenz DR,Gordon SCdoi
10.1007/s10620-014-3272-6subject
Has Abstractpub_date
2014-12-01 00:00:00pages
3053-61issue
12eissn
0163-2116issn
1573-2568journal_volume
59pub_type
杂志文章abstract:BACKGROUND:A role of an altered dietary pattern (e.g., a diet rich in sugar) but also alterations at the level of the intestinal barrier have repeatedly been discussed to be involved in the development and progression of nonalcoholic fatty liver disease (NAFLD). AIMS:To determine if the nutritional intake, intestinal ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-012-2112-9
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abstract::To investigate a potential new treatment for gastric Helicobacter pylori infection, we have examined the use of the natural antibiotic lactoferrin, found in bovine milk, for activity against Helicobacter species both in vitro and in vivo. Lactoferrin was bacteriostatic to H. pylori when cultured at concentrations > or...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1026675916421
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abstract::Since granulocyte elastase has been shown to be involved in the pathogenesis of gastric mucosal lesion formation induced by nonsteroidal antiinflammatory drugs, inhibition of granulocyte elastase release from neutrophils may be useful in the prevention of these lesions. The objective of this study was to determine whe...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::Clinical observations reveal that alcohol intake is associated with an increase in upper gastrointestinal hemorrhage requiring hospitalization and that nitroglycerin or long-acting nitrates lower this risk. Nitroglycerin, a gastric vasodilator that can increase gastric fluid volume, protects the rodent stomach against...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-006-9692-1
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abstract:BACKGROUND:While the short-term benefits of exclusive enteral nutrition (EEN) for induction of remission in children with Crohn's disease (CD) are well documented, the longer-term outcomes are less clear. AIM:This retrospective study aimed to ascertain the outcomes for up to 24 months following EEN in a group of child...
journal_title:Digestive diseases and sciences
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doi:10.1007/s10620-012-2232-2
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journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章,随机对照试验
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abstract:BACKGROUND:Intraductal ultrasonography (IDUS) is a useful procedure for diagnosing microlithiasis in the bile duct but it is not easy to differentiate between tiny echogenicity and real microlithiasis. We compared the echogenicity seen on IDUS and the findings of bile microscopy (BM) of bile that was collected in the c...
journal_title:Digestive diseases and sciences
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doi:10.1007/s10620-009-0770-z
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01311246
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abstract::In 1958 the Yale freshman class gave blood samples as part of a study intended to determine the predictive value of plasma pepsinogen (PP) for the subsequent development of duodenal ulcer (DU). We report a long-term follow-up of this cohort. A self-administered questionnaire designed to ascertain information about the...
journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
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doi:10.1007/s10620-006-9281-3
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journal_title:Digestive diseases and sciences
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doi:10.1007/s10620-009-1005-z
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abstract::Our purpose is to develop a standard method for preparing the bile for beta-glucuronidase determination by removal of bile acids and conjugated bilirubin which interfere with its activity. The bile acids and conjugated bilirubin in their purified solutions and in the diluted gallbladder biles could be extracted comple...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01536028
更新日期:1988-04-01 00:00:00
abstract::This study assessed the mucosal antioxidant response during acute (mouse) and chronic (adult human) H. pylori infection and following N-acetylcysteine administration. Antral biopsies were obtained from 44 patients (16 infected, 28 noninfected). Sixty-nine mice were sacrificed after 1 (n = 25), 4 (n = 28), or 6 (n = 16...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/b:ddas.0000037796.64430.f6
更新日期:2004-08-01 00:00:00
abstract:INTRODUCTION:Increased nonacid reflux is diagnosed in a subgroup of patients with gastroesophageal reflux disease who often present with reflux symptoms refractory to proton-pump inhibitor therapy. Despite the prevalence of this condition, the management approach for patients with increased nonacid reflux can often be ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-020-06348-6
更新日期:2020-05-23 00:00:00
abstract::Studies of the T-cell-receptor repertoire and oligoclonal expansion of lamina propria T cells in patients with Crohn's disease suggest restricted antigen processing in this disease. We examined HPLC elution profiles of HLA-DR-bound peptides isolated from human intestine. Surgical samples of colon and ileum were obtain...
journal_title:Digestive diseases and sciences
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doi:10.1023/a:1019689332601
更新日期:2002-09-01 00:00:00
abstract::Nitric oxide mediates neuromuscular events in the opossum esophagus. The NADPH diaphorase stain is used to localize nitric oxide synthase-containing enteric neurons. Cells stain by the NADPH diaphorase technique because they reduce nitroblue tetrazolium to the visible formazan. The effects of nitroblue tetrazolium on ...
journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章,随机对照试验
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journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
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