The Science of Prevention Strategies

From newborn screening for Phenylkentonurea (PKU) and the birth dose of Hepatitis B vaccine to prostate and breast cancer screening and pneumococcal immunization for older adults, the science of health maintenance is multi-tiered and spans the lifetime of an individual. Primary, secondary, and tertiary prevention strategies are used in concert with each other to enable healthcare professionals and their patients to sustain and improve the quality of life

Machine learning applied to the h index of colombian authors with publications in scopus

Our research aims to establish how to predict the H index of Colombian authors with publications in Scopus until 2016. The selection of the date was because, as mentioned earlier, the number of documents indexed per year exceeded 10,000 and they obtained the highest number of documents cited. To accomplish this purpose, a quantitative, nonexperimental, cross-sectional, descriptive, explanatory, and predictive research was designed using supervised learning algorithms. These were applied to information from 8,840 Colombian authors. Among the findings we can highlight that: (i) Colombia is in the fifth position in the scope of countries of South America and the Caribbean, in terms of the number of products and citations; (ii) the largest number of Colombian authors with products in Scopus until 2016, belonged mainly to the area of natural sciences, followed by medical sciences and health; (iii) most of the Colombian authors were men (64.2%, or 5,442) and they have higher H index rates than women; (iv) using random cross validation for 10 iterations, the methods with the best predictive value using R2 and the minimization of mean absolute error (MAE) correspond to: AdaBoost (96.6% and 0.397, respectively); Random Forest (96.8% and 0.431, respectively); KNN (94.4% and 0.525, respectively); Tree (94.9% and 0.53, respectively); and Neural Network (93.3% and 0.7, respectively); and (v) the variables that help predict the H index in the case of the Colombian authors, in addition to the citations, correspond to: the quantity of products, number of products in Q1, and international collaboratio

Best practice considerations on the assessment of robotic assisted surgical systems:results from an international consensus expert panel

Background Health technology assessments (HTAs) of robotic assisted surgery (RAS) face several challenges in assessing the value of robotic surgical platforms. As a result of using different assessment methods, previous HTAs have reached different conclusions when evaluating RAS. While the number of available systems and surgical procedures is rapidly growing, existing frameworks for assessing MedTech provide a starting point, but specific considerations are needed for HTAs of RAS to ensure consistent results. This work aimed to discuss different approaches and produce guidance on evaluating RAS. Methods A consensus conference research methodology was adopted. A panel of 14 experts was assembled with international experience and representing relevant stakeholders: clinicians, health economists, HTA practitioners, policy makers, and industry. A review of previous HTAs was performed and seven key themes were extracted from the literature for consideration. Over five meetings, the panel discussed the key themes and formulated consensus statements. Results A total of ninety-eight previous HTAs were identified from twenty-five total countries. The seven key themes were evidence inclusion and exclusion, patient- and clinician-reported outcomes, the learning curve, allocation of costs, appropriate time horizons, economic analysis methods, and robotic ecosystem/wider benefits. Conclusions Robotic surgical platforms are tools, not therapies. Their value varies according to context and should be considered across therapeutic areas and stakeholders. The principles set out in this paper should help HTA bodies at all levels to evaluate RAS. This work may serve as a case study for rapidly developing areas in MedTech that require particular consideration for HTAs.</p

Clinical Course, Imaging Features, and Outcomes of COVID-19 in Kidney Transplant Recipients

Coronavirus disease 2019 (COVID-19) is a novel and highly contagious disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older adults and patients with comorbidities and immunosuppressive conditions may experience severe signs and symptoms that can lead to death. This case series assesses the clinical course, imaging features, and outcomes for 12 patients with COVID-19 and a history of kidney transplantation. Patients were evaluated for symptoms, laboratory data, imaging findings, and outcomes from February 2020 to April 2020. Fever, cough, and dyspnea were the most common clinical symptoms, noted in 75 (nine/12), 75 (nine/12), and 41.7 (five/12) of the patients, respectively. Most of the patients had a normal white blood cell count, while 33.3 (four/12) had leukopenia and 8.3 (one/12) had leukocytosis. A combination of consolidation and ground glass opacity was the most predominant (75) pattern of lung involvement on computed tomography (CT). Eight patients died of severe COVID-19 pneumonia and acute respiratory distress syndrome and four were discharged. All recovered cases had a unilateral peripheral pattern of involvement limited to only one zone on initial chest CT. It seems that CT imaging has an important role in predicting COVID-19 outcomes for solid organ transplant recipients. Future studies with long-term follow up and more cases are needed to elucidate COVID-19 diagnosis, outcome, and management strategies for these patients. © 2020 European Association of Urolog