1,860 research outputs found
Technical Workshop: Advanced Helicopter Cockpit Design
Information processing demands on both civilian and military aircrews have increased enormously as rotorcraft have come to be used for adverse weather, day/night, and remote area missions. Applied psychology, engineering, or operational research for future helicopter cockpit design criteria were identified. Three areas were addressed: (1) operational requirements, (2) advanced avionics, and (3) man-system integration
Angiostomy cannulae for the study of pulmonary circulation
Project Number 22-1301-0002 Research ReportAF Contract Number 18(600)-41
Deriving research-quality phenotypes from national electronic health records to advance precision medicine: a UK Biobank case-study
High-throughput genotyping and increased
availability of electronic health records (EHR) are giving
scientists the unprecedented opportunity to exploit routinely
generated clinical data to advance precision medicine. The
extent to which national structured EHR in the United Kingdom
can be utilized in genome-wide association studies (GWAS) has
not been systematically examined. In this study, we evaluate the
performance of an EHR-derived acute myocardial infarction
phenotype (AMI) for performing GWAS in the UK Biobank
Underuse of coronary revascularization procedures in patients considered appropriate candidates for revascularization.
Background: Ratings by an expert panel of the appropriateness of treatments may offer better guidance for clinical practice than the variable decisions of individual clinicians, yet there have been no prospective studies of clinical outcomes. We compared the clinical outcomes of patients treated medically after angiography with those of patients who underwent revascularization, within groups defined by ratings of the degree of appropriateness of revascularization in varying clinical circumstances.Methods: This was a prospective study of consecutive patients undergoing coronary angiography at three London hospitals. Before patients were recruited, a nine-member expert panel rated the appropriateness of percutaneous transluminal coronary angioplasty (PTCA) and coronary-artery bypass grafting (CABG) on a nine-point scale (with 1 denoting highly inappropriate and 9 denoting highly appropriate) for specific clinical indications. These ratings were then applied to a population of patients with coronary artery disease. However, the patients were treated without regard to the ratings. A total of 2552 patients were followed for a median of 30 months after angiography.Results: Of 908 patients with indications for which PTCA was rated appropriate (score, 7 to 9), 34 percent were treated medically; these patients were more likely to have angina at follow-up than those who underwent PTCA (odds ratio, 1.97; 95 percent confidence interval, 1.29 to 3.00). Of 1353 patients with indications for which CABG was considered appropriate, 26 percent were treated medically; they were more likely than those who underwent CABG to die or have a nonfatal myocardial infarction - the composite primary outcome (hazard ratio, 4.08; 95 percent confidence interval, 2.82 to 5.93) - and to have angina (odds ratio, 3.03; 95 percent confidence interval, 2.08 to 4.42). Furthermore, there was a graded relation between rating and outcome over the entire scale of appropriateness (P for linear trend = 0.002).Conclusions: On the basis of the ratings of the expert panel, we identified substantial underuse of coronary revascularization among patients who were considered appropriate candidates for these procedures. Underuse was associated with adverse clinical outcomes. (N Engl J Med 2001;344:645-54.) Copyright (C) 2001 Massachusetts Medical Society
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