Analytics4Action Evaluation Framework: A Review of Evidence-Based Learning Analytics Interventions at the Open University UK

There is an urgent need to develop an evidence-based framework for learning analytics whereby stakeholders can manage, evaluate, and make decisions about which types of interventions work well and under which conditions. In this article, we will work towards developing a foundation of an Analytics4Action Evaluation Framework (A4AEF) that is currently being tested and validated at the Open University UK. By working with 18 introductory large-scale modules for a period of two years across the five faculties and disciplines within the OU, Analytics4Action provides a bottom-up-approach for working together with key stakeholders within their respective contexts. A holistic A4AEF has been developed to unpack, understand and map the six key steps in the evidence-based intervention process. By means of an exemplar in health and social science, a practical illustration of A4AEF is provided. In the next 3-5 years, we hope that a rich, robust evidence-base will be presented to show how learning analytics can help teachers to make informed, timely and successful interventions that will help each learner to achieve the module’s learning outcomes

Improvement in left ventricular ejection fraction after pharmacological up-titration in new-onset heart failure with reduced ejection fraction

OBJECTIVE: Recent studies have reported suboptimal up-titration of heart failure (HF) therapies in patients with heart failure and a reduced ejection fraction (HFrEF). Here, we report on the achieved doses after nurse-led up-titration, reasons for not achieving the target dose, subsequent changes in left ventricular ejection fraction (LVEF), and mortality. METHODS: From 2012 to 2018, 378 HFrEF patients with a recent (< 3 months) diagnosis of HF were referred to a specialised HF-nurse led clinic for protocolised up-titration of guideline-directed medical therapy (GDMT). The achieved doses of GDMT at 9 months were recorded, as well as reasons for not achieving the optimal dose in all patients. Echocardiography was performed at baseline and after up-titration in 278 patients. RESULTS: Of 345 HFrEF patients with a follow-up visit after 9 months, 69% reached ≥ 50% of the recommended dose of renin-angiotensin-system (RAS) inhibitors, 73% reached ≥ 50% of the recommended dose of beta-blockers and 77% reached ≥ 50% of the recommended dose of mineralocorticoid receptor antagonists. The main reasons for not reaching the target dose were hypotension (RAS inhibitors and beta-blockers), bradycardia (beta-blockers) and renal dysfunction (RAS inhibitors). During a median follow-up of 9 months, mean LVEF increased from 27.6% at baseline to 38.8% at follow-up. Each 5% increase in LVEF was associated with an adjusted hazard ratio of 0.84 (0.75–0.94, p = 0.002) for mortality and 0.85 (0.78–0.94, p = 0.001) for the combined endpoint of mortality and/or HF hospitalisation after a mean follow-up of 3.3 years. CONCLUSIONS: This study shows that protocolised up-titration in a nurse-led HF clinic leads to high doses of GDMT and improvement of LVEF in patients with new-onset HFrEF. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-021-01591-6) contains supplementary material, which is available to authorized users

The effects of responsible drinking messages on attentional allocation and drinking behaviour.

AIMS: Four experiments were conducted to assess the acute impact of context and exposure to responsible drinking messages (RDMs) on attentional allocation and drinking behaviour of younger drinkers and to explore the utility of lab-based methods for the evaluation of such materials. METHODS: A simulated bar environment was used to examine the impact of context, RDM posters, and brief online responsible drinking advice on actual drinking behaviour. Experiments one (n = 50) and two (n = 35) comprised female non-problem drinkers, whilst Experiments three (n = 80) and 4 (n = 60) included a mixed-gender sample of non-problem drinkers, recruited from an undergraduate student cohort. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess drinking patterns. Alcohol intake was assessed through the use of a taste preference task. RESULTS: Drinking in a simulated bar was significantly greater than in a laboratory setting in the first two studies, but not in the third. There was a significant increase in alcohol consumption as a result of being exposed to RDM posters. Provision of brief online RDM reduced the negative impact of these posters somewhat; however the lowest drinking rates were associated with being exposed to neither posters nor brief advice. Data from the final experiment demonstrated a low level of visual engagement with RDMs, and that exposure to posters was associated with increased drinking. CONCLUSIONS: Poster materials promoting responsible drinking were associated with increased consumption amongst undergraduate students, suggesting that poster campaigns to reduce alcohol harms may be having the opposite effect to that intended. Findings suggest that further research is required to refine appropriate methodologies for assessing drinking behaviour in simulated drinking environments, to ensure that future public health campaigns of this kind are having their intended effect

The Need for Routine Native Nephrectomy in the Workup for Kidney Transplantation in Autosomal Dominant Polycystic Kidney Disease Patients

Introduction: There is no consensus if nor when a native nephrectomy should be performed in the workup for kidney transplantation in ADPKD patients. In our PKD Expertise Center, a restrictive approach is pursued in which nephrectomy is performed only in patients with severe complaints, i.e., in case of serious volume-related complaints, lack of space for the allograft, recurrent cyst infections, persistent cyst bleedings, or chronic refractory pain. We analyzed in a retrospective cohort study whether this approach is justified. Methods: All ADPKD patients who received kidney transplantation between January 2000 and January 2019 were reviewed. Patients were subdivided into three groups: no nephrectomy (no-Nx), nephrectomy performed before (pre-Tx), or after kidney transplantation (post-Tx). Simultaneous nephrectomy together with transplantation were not performed in our center. Results: 391 patients (54 +/- 9 years, 55% male) were included. The majority of patients did not undergo a nephrectomy (n = 257, 65.7%). A nephrectomy was performed pre-Tx in 114 patients (29.2%). After Tx, nephrectomy was performed in only 30 patients (7.7%, median 4.4 years post-Tx). Surgery-related complication rates did not differ between both groups (38.3% pre-Tx vs. 27.0% post-Tx, p = 0.2), nor were there any differences in 10-year patient survival (74.4% pre-Tx vs. 80.7% post-Tx vs. 67.6% no-Nx, p = 0.4), as well as in 10-year death-censored graft survival (84.4% pre-Tx vs. 85.5% post-Tx vs. 90.0% no-Nx, p = 0.9). Conclusions: This study indicates that with a restrictive nephrectomy policy in the workup for kidney transplantation, only a part of ADPKD patients need a native nephrectomy