Understanding challenges and success factors in creating a data-driven culture

Increasingly, organizations aspire to practices of data-driven decision making. The necessary transformation to a data-driven culture poses challenges, and this paper explores these as well as success factors. The study is based on six in-depth case studies of organizations that are in different phases of their transformation towards a data-driven organization. Propositions derived from change management and digital transformation literature guide our exploration. Our findings show how challenges and responses differ across the various stages of the transformation. Challenges include resistance to new technology; rigid organizational structures; and too little focus on usable analyses. Success factors include clear communication and leading by example by top-management; showing relevant and clear results of the transformation; and openness to experimentation. A discussion of implications and future research directions rounds off the paper

Glomerulonephritis and malignancy: A population-based analysis

Glomerulonephritis and malignancy: A population-based analysis.BackgroundAn association between glomerulonephritis and malignant tumors has previously both been found and discarded in clinical series, but to our knowledge never has been tested in a population-based setting.MethodsThe Danish Kidney Biopsy Registry includes all kidney biopsies performed from 1985. Using a unique personal identification number, each person in the registry to the National Population Registry and the Danish Cancer Registry were linked. Cancer occurrence after the biopsy was compared in patients with morphological, glomerular diseases with that of the general Danish population, taking into account sex, age, calendar period and time since biopsy, and the 95% confidence interval (95% CI) for the observed-to-expected rates was calculated, assuming a Poisson distribution. Cancer occurrence was stratified to <1 year, 1 to 4, and ≥5 years after a biopsy.ResultsA total of 102 de novo cancers were found in 1958 patients. These cancers represent a two- to threefold excess of the expected number at <1 and 1 to 4, but not ≥5 years after a biopsy. Non-Hodgkin's lymphomas were observed six to eight times more than expected. Cancer excess was seen in glomerulonephritides with a known or suspected virus etiology.ConclusionsThe excess cancer rate could be the result of underlying undiagnosed tumors whose antigens have initiated glomerulonephritis, or the immunosuppressive therapy that initiated or energized tumor cells. Based on the findings in our study, there is some support for an association to persistent viruses causing first the glomerulonephritides and then the malignancies, perhaps through a common pathogenesis. This calls for other studies to be done that are specifically designed to investigate this issue, with more data on patient characteristics and confounders

Insight into the 17th-Century Bead Industry of Middelburg, the Netherlands

During the first half of the 17th century, several beadmaking establishments operated in the city of Middelburg in the southwestern corner of the Netherlands. Bead wasters recovered from several find sites in the old part of the city reveal the diversity of the product line which featured beads decorated with straight and spiral stripes. Several chevron types were also produced. There are similarities with wasters found at contemporary beadmaking sites in Amsterdam, indicating that both production centers made similar bead varieties. Few of the bead varieties represented have correlatives in the areas of North America that were under Dutch control, leaving one guessing what market the Middelburg beads were destined for. In that the city was a major center for the Dutch East India Company, it may be that their market was in that part of the world. Unfortunately, comparative material from South and Southeast Asia is currently lacking

The Risk of Cancer Among Patients Previously Hospitalized for Atopic Dermatitis

In treatment of severe atopic dermatitis, drugs with carcinogenic potentials are used to manage the disease. We therefore analyzed whether patients having severe atopic eczema had an increased cancer risk. The study population included all individuals hospitalized in Denmark with a primary diagnosis of atopic dermatitis during 1977–1996. Follow-up was conducted in 1996 in the Danish Cancer Register. A total of 6275 persons were included. Among 2030 adult patients, an increased risk of cancer was observed, standard morbidity ratio (SMR)=1.5 (95% CI: 1.2–1.9). Half the excess cases of cancer was keratinocyte carcinomas of the skin diagnosed within the first 9 y of follow–up, SMR=2.4 (95% CI: 1.4–3.9). For men, SMR=2.7 (95%CI: 1.2–5.4). In conclusion, earlier hospitalized adult atopic dermatitis patients had an increased risk of cancer. Half the excess cases of cancer were keratinocyte carcinomas. This may be a result of a detection bias or due to the carcinogenic potentials of some of the therapies of severe atopic dermatitis

The Risk of Cancer Among Patients Previously Hospitalized for Atopic Dermatitis

In treatment of severe atopic dermatitis, drugs with carcinogenic potentials are used to manage the disease. We therefore analyzed whether patients having severe atopic eczema had an increased cancer risk. The study population included all individuals hospitalized in Denmark with a primary diagnosis of atopic dermatitis during 1977–1996. Follow-up was conducted in 1996 in the Danish Cancer Register. A total of 6275 persons were included. Among 2030 adult patients, an increased risk of cancer was observed, standard morbidity ratio (SMR)=1.5 (95% CI: 1.2–1.9). Half the excess cases of cancer was keratinocyte carcinomas of the skin diagnosed within the first 9 y of follow–up, SMR=2.4 (95% CI: 1.4–3.9). For men, SMR=2.7 (95%CI: 1.2–5.4). In conclusion, earlier hospitalized adult atopic dermatitis patients had an increased risk of cancer. Half the excess cases of cancer were keratinocyte carcinomas. This may be a result of a detection bias or due to the carcinogenic potentials of some of the therapies of severe atopic dermatitis

Colorectal cancer - Demand for a joint Nordic study on the value of colonoscopic screening

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A statistical analysis protocol for the time-differentiated target temperature management after out-of-hospital cardiac arrest (TTH48) clinical trial

Background The TTH48 trial aims to determine whether prolonged duration (48 hours) of targeted temperature management (TTM) at 33 (±1) °C results in better neurological outcomes compared to standard duration (24 hours) after six months in comatose out-of-hospital cardiac arrest (OHCA) patients. Methods TTH48 is an investigator-initiated, multicentre, assessor-blinded, randomised, controlled superiority trial of 24 and 48 hours of TTM at 33 (±1) ° C performed in 355 comatose OHCA patients aged 18 to 80 years who were admitted to ten intensive care units (ICUs) in six Northern European countries. The primary outcome of the study is the Cerebral Performance Category (CPC) score observed at six months after cardiac arrest. CPC scores of 1 and 2 are defined as good neurological outcomes, and CPC scores of 3, 4 and 5 are defined as poor neurological outcomes. The secondary outcomes are as follows: mortality within six months after cardiac arrest, CPC at hospital discharge, Glasgow Coma Scale (GCS) score on day 4, length of stay in ICU and at hospital and the presence of any adverse events such as cerebral, circulatory, respiratory, gastrointestinal, renal, metabolic measures, infection or bleeding. With the planned sample size, we have 80% power to detect a 15% improvement in good neurological outcomes at a two-sided statistical significance level of 5%. Discussion We present a detailed statistical analysis protocol (SAP) that specifies how primary and secondary outcomes should be evaluated. We also predetermine covariates for adjusted analyses and pre-specify sub-groups for sensitivity analyses. This pre-planned SAP will reduce analysis bias and add validity to the findings of this trial on the effect of length of TTM on important clinical outcomes after cardiac arrest. Trial registration ClinicalTrials.gov: NCT01689077, 17 September 201

Screening for colorectal cancer. Collaboration among politicians and scientists is necessary

Hægt er að lesa greinina í heild sinni með því að smella á hlekkinn View/OpenColorectal cancer is one of the most common cancers in the western world. It is especially common in the Nordic countries. In many of the European countries and in the United States colonoscopy is recommended as a screening procedure for CRC. However, there are no randomized studies of the effects of the method on incidence, mortality, possible complications or negative effects on the population. Public pressure to have screening for CRC with colonoscopy will probably increase heavily in the next years to come. We fear that colonoscopy will be introduced as a screening method without proper scientific support. Therefore we want to argue for a common Nordic randomized study on population screening with colonoscopy.Krabbamein í ristli og endaþarmi er eitt af algengustu krabbameinum í hinum vestræna heimi, og sérstaklega er það algengt á Norðurlöndum. Í mörgum Evrópulöndum og Bandaríkjunum er ristilspeglun ráðlögð sem skimunaraðferð fyrir þessu krabbameini. Það hafa samt ekki verið gerðar slembirannsóknir á áhrifum aðferðarinnar á nýgengi, dánartíðni, mögulega fylgikvilla eða neikvæð áhrif á almenning. Þrýstingur almennings á að fá skimun fyrir meininu með ristilspeglun mun líklega aukast mikið á næstu árum. Það er hætta á því að ristilspeglun sem skimunaraðferð verði innleidd án nægilegrar vísindalegrar undirstöðu. Þess vegna viljum við færa rök fyrir mikilvægi þess að gerð verði samnorræn slembirannsókn á skimun með ristilspeglun meðal almennings