The Role of Signal Detection in Pharmacovigilance

The World Health Organisation defines pharmacovigilance as the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. Signal detection is a core pharmacovigilance activity. The motivation behind exploring signal detection and evaluation process is the timely detection of safety issues, and ultimately a better protection of public health. This thesis aimed to explore the processes of signal detection and evaluation and to inform regulatory decision making by providing evidence-based solutions to some of the existing questions. We investigated methods of detection and alternative data sources. Furthermore, we were interested to find out which characteristics of drugs make them more prone to have safety issues discovered post-marketing and tried to find predictive characteristics and we tried to gain some insight in the prioritisation process. The current work is relevant for all involved stakeholders, as European Medicines Agency (EMA), national regulatory authorities, pharmaceutical industry and, healthcare professionals and researchers

Use of Decision Tables to Model Assistance Knowledge to Train Medical Residents

En aquesta tesi es presenta un model de coneixement clínic basat en taules de decisió que permet representar les fases de diagnòstic, tractament i pronòstic de diferents malalties. Les taules de decisió que s'obtenen per a cada fase del model han estat utilitzades per representar malalties reals a partir de guies de pràctica clínica. En el cas del diagnòstic s'han representat les vuit causes secundàries més comuns de la hipertensió arterial. En el cas del tractament i pronòstic s'han representat set diferents xocs en emergències. Les taules de decisió que hem obtingut per a cadascuna de les malalties s'han utilitzat com a base per crear dues eines d'entrenament mèdic, dirigides a residents. Totes dues eines s'han provat a l'Hospital Clínic de Barcelona amb diferents grups de residents. Després de les proves s'ha conclòs que les taules de decisió són adequades per a la representació del coneixement mèdic en totes tres fases. A més, les eines d'aprenentatge han estat efectives a l'hora d'ensenyar els procediments mèdics, especialment als residents amb menys experiència prèvia.En esta tesis se presenta un modelo de conocimiento clínico basado en tablas de decisión que permite representar las fases de diagnostico, tratamiento y pronostico de distintas enfermedades. Las tablas de decisión que se obtienen para cada fase del modelo han sido utilizadas para representar enfermedades reales a partir de guías de práctica clínica. En el caso del diagnóstico se han representado las ocho causas secundarias más comunes de la hipertensión arterial. En el caso del tratamiento y pronóstico se han representado siete diferentes shocks en emergencias. Las tablas de decisión que hemos obtenido para cada una de las enfermedades se han usado como base para crear dos herramientas de entrenamiento médico, dirigido a residentes. Ambas herramientas se han probado en el Hospital Clínic de Barcelona con distintos grupos de residentes. Tras las pruebas se ha concluido que las tablas de decisión son adecuadas para la representación del conocimiento medico en las tres fases. Además, las herramientas de aprendizaje han sido efectivas a la hora de enseñar los procedimientos médicos, en especial a los residentes con menos experiencia previa.In this thesis a clinical knowledge model based on decision tables is presented. This model allows us to represent the stages of diagnosis, treatment, and prognosis of different diseases. The decision tables obtained for each phase of the model have been used to represent real diseases from clinical practice guidelines. In the case of diagnosis, we represented eight of the most common secondary causes of hypertension. For the treatment and prognosis we represented seven different emergency shocks. The decision tables obtained for each disease have been used as the basis for two medical training tools aimed to residents. Both tools have been tested in the Hospital Clínic de Barcelona with different groups of residents. After testing, it was concluded that decision tables are suitable for the representation of medical knowledge in all three phases. In addition, the learning tools have been effective in teaching medical procedures, especially for untrained residents

An Analysis of the Allergy Comments on Twitter Using Data Mining Approach

Allergies are one of the most common chronic illnesses in the world. The prevalence of social media allows people to express their opinions and exchange information including symptoms of personal health. Mining those publicly accessible health-related data on social media, such as Twitter, offers a unique approach to get valuable healthcare insights. In this paper, a multi-component data mining framework was developed to collect Twitter data, detect time series patterns, discover topics of interest about allergies, and analyze the contents of tweets. From the extracted 2.2 million tweets in 2019, my experimental results show that allergy-related tweet volume is strongly correlated to the pollen data (r = .699, p < .01). Also, 152 unique topics are identified with a -28.36 perplexity score and a .67 coherence score. Furthermore, many linguistic dimensions such as the sentiment are analyzed to learn about the tweet contents. I consider this to be one of the many studies examining a large-scale social media stream to deeply analyze allergy activities. And with the growing social media, publicly available data such as Twitter posts can be used to support healthcare practitioners and social scientists in better understanding common public opinions, not just allergies.Master of Scienc

Advisory Committee on Immunization Practices (ACIP) summary report : June 26-27, 2019, Atlanta, Georgia

Publication date from document properties.min-2019-06.pdf2019683

Visual Impairment and Blindness

Blindness and vision impairment affect at least 2.2 billion people worldwide with most individuals having a preventable vision impairment. The majority of people with vision impairment are older than 50 years, however, vision loss can affect people of all ages. Reduced eyesight can have major and long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities, and the ability to access public services. This book provides an overview of the effects of blindness and visual impairment in the context of the most common causes of blindness in older adults as well as children, including retinal disorders, cataracts, glaucoma, and macular or corneal degeneration