A screening, referral, and follow-up program for high blood pressure at Henry Ford Hospital: Part II. Results of referral and follow-up

This is the second of two articles on the Henry Ford Hospital screening, referral, and follow-up program for high blood pressure. The first reported on the screening results of the program, along with associated epidemiological findings. This article presents the results of referral and follow-up. During the period of March 27 through December 11, 1975, 808 people were screened; 196 (24%) were found to have uncontrolled high blood pressure and were referred to physicians for diagnosis and possible treatment for hypertension. The program is currently following up with these people and their physicians to insure successful referral and maintenance of treatment. This paper outlines the overall procedures used for screening, referral, and long-range follow-up. It also presents an evaluation of these procedures, along with outcome data after an average duration often months of follow-up. As of June, 1976, the success rates recorded by the program Include the following: (a) of all people referred for high blood pressure, 86% were successfully referred (had visited a physician for this condition); (b) of the group successfully referred, 90% had entered (or re-entered) treatment for hypertension; and (c) of those under treatment, 67% were showing successful treatment (blood pressure below 140/90) or progressing toward successful treatment (blood pressure below the screening levels of 160/96)

Saving Lives and Dollars Through Comprehensive Preventive Health Care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68280/2/10_1111_j_1741-6248_1993_00163_x.pd

Worksite Follow-Up and Engagement Strategies for Initiating Health Risk Behavior Changes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66663/2/10.1177_109019819001700409.pd

A family set method for estimating heredity and stress--I : A pilot survey of blood pressure among Negroes in high and low stress areas, Detroit, 1966-1967

A pilot survey designed to test the feasibility of measuring genetic and stress variables as they relate to blood pressure levels was carried out among Negroes residing in high and low stress census tracts in Detroit, 1966-1967. Fifty-six "family sets" or 280 persons were interviewed and blood pressure recordings were taken by trained nurses. Each family set was composed of an index, a spouse, a sibling and a first cousin of index, and an unrelated person in the census tract matched to index. The method and findings of obtaining such family sets is discussed and found to be encouraging enough to initiate a larger study. It was also found that proportions of persons with hypertensive levels were significantly greater in the high stress tract (32 per cent; N = 102) than in the low stress tract (19 per cent; N = 113).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32720/1/0000088.pd

A family set method for estimating heredity and stress--II : Preliminary results of the genetic methodology in a pilot survey of Negro blood pressure, Detroit, 1966-1967

A prior article described in detail a pilot survey designed to measure the effects of heredity and stress on blood pressures among Negroes residing in high and low stress census tracts in Detroit. This report outlines the construction of a genetic variable to analyze the heritable component in blood pressure variability using a family set composed of an index and spouse, a sibling and a first cousin of index, and an unrelated person in the tract matched to index. Given the theoretical proportions describing the degree to which genes are shared between siblings and first cousins, then it follows that variability of a given trait will increase predictably within each family set. Findings from a limited sample of 56 family sets indicate support for a genetic distance scale when measured against variables such as height and skin color; however, the relationship with blood pressure levels is inconclusive. A study now underway will more critically test the tentative findings from this pilot survey.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32721/1/0000089.pd

Deep Learning for Identification of Acute Illness and Facial Cues of Illness

Background: The inclusion of facial and bodily cues (clinical gestalt) in machine learning (ML) models improves the assessment of patients' health status, as shown in genetic syndromes and acute coronary syndrome. It is unknown if the inclusion of clinical gestalt improves ML-based classification of acutely ill patients. As in previous research in ML analysis of medical images, simulated or augmented data may be used to assess the usability of clinical gestalt. Objective: To assess whether a deep learning algorithm trained on a dataset of simulated and augmented facial photographs reflecting acutely ill patients can distinguish between healthy and LPS-infused, acutely ill individuals. Methods: Photographs from twenty-six volunteers whose facial features were manipulated to resemble a state of acute illness were used to extract features of illness and generate a synthetic dataset of acutely ill photographs, using a neural transfer convolutional neural network (NT-CNN) for data augmentation. Then, four distinct CNNs were trained on different parts of the facial photographs and concatenated into one final, stacked CNN which classified individuals as healthy or acutely ill. Finally, the stacked CNN was validated in an external dataset of volunteers injected with lipopolysaccharide (LPS). Results: In the external validation set, the four individual feature models distinguished acutely ill patients with sensitivities ranging from 10.5% (95% CI, 1.3–33.1% for the skin model) to 89.4% (66.9–98.7%, for the nose model). Specificity ranged from 42.1% (20.3–66.5%) for the nose model and 94.7% (73.9–99.9%) for skin. The stacked model combining all four facial features achieved an area under the receiver characteristic operating curve (AUROC) of 0.67 (0.62–0.71) and distinguished acutely ill patients with a sensitivity of 100% (82.35–100.00%) and specificity of 42.11% (20.25–66.50%). Conclusion: A deep learning algorithm trained on a synthetic, augmented dataset of facial photographs distinguished between healthy and simulated acutely ill individuals, demonstrating that synthetically generated data can be used to develop algorithms for health conditions in which large datasets are difficult to obtain. These results support the potential of facial feature analysis algorithms to support the diagnosis of acute illness

Socioecological stressor areas and black-white blood pressure: Detroit

1. 1. Blood pressure does appear to vary with `socioecological niches' or combinations of sex, race and residence, which reflect social class position as well as degree of social stressor conditions. Black High Stress males had higher adjusted levels than Black Low Stress males, while White High Stress females had higher adjusted pressures than White Low Stress females. Black High Stress females had significantly higher observed levels than Black Low Stress females.2. 2. Black High Stress males had a significantly higher per cent of Borderline and Hypertensive blood pressure than other male race-area groups; White Low Stress females had the lowest of all eight sex-race-stress area groups.3. 3. For Black males, the younger, overweight High Stress residents had significantly higher Borderline and Hypertensive levels than did a similar Black Low Stress subgroup. Further, for both groups, being raised in Detroit and not migrating from elsewhere was related to higher readings. Tests for age-stress area interaction, however, were not significant.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33823/1/0000080.pd

Controlling hypertension: A cost-effective model

A model system for controlling hypertension that was developed and tested in three industrial settings and three community settings is described. DataPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22912/1/0000477.pd

A screening, referral, and follow-up program for high blood pressure at Henry Ford Hospital: Part I. Results of screening

Data are reported on the screening results from the Henry Ford Hospital screening, referral and follow-up program for high blood pressure. The report covers the period of March 27 through December 11, 1975, during which time 808 people were screened in the hospital lobby. Thirty-nine percent were found upon initial screening to have high blood pressure readings or previously diagnosed hypertension. Of these people, 70% were already under treatment for hypertension, but only 21% showed adequate blood pressure control (with readings below 140/90 mm Hg). Those with high readings were referred to their physicians. A paper on the results of follow-up Is being prepared. Relationships are presented between high blood pressure and age, sex, race, education, percent overweight, marital status, employment status, and history of cardiovascular disease. For diagnosed hypertensives, several aspects of treatment are related to adequacy of blood pressure control

Heredity, stress and blood pressure, a family set method--I : Study aims and sample flow

This first article, in a series of five, describes the method of sampling family sets. Family sets are composed of three persons having a genetic relation: an index, his/her sibling and first cousin, and two persons having an environmental nexus, a spouse of index and an unrelated person matched to the index. The target populations were four census areas in Detroit, a black high stress area, a black low stress area, a white high stress, and a white low stress area. These areas were selected by a factor analysis of census rates which indicated extremes of Stressor conditions. Within each area a complete census was taken, potential sample members were selected and verified by another interviewer, then assigned as an index; sibs and first cousins, selected as closest in age to index, were verified independently, then an unrelated person was chosen, and all five persons were independently interviewed and blood pressures taken. This article details the full sampling process in each of the four census areas, and tests the final sample of 461 family sets in several ways which confirmed expectations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22833/1/0000393.pd