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3. Coarse race data conceals disparities in clinical risk score performance

Author

Movva, Rajiv, Shanmugam, Divya, Hou, Kaihua, Pathak, Priya, Guttag, John, Garg, Nikhil, and Pierson, Emma

Subjects
Computer Science - Computers and Society, Computer Science - Machine Learning, Statistics - Applications, J.3, K.4.2
Abstract

Healthcare data in the United States often records only a patient's coarse race group: for example, both Indian and Chinese patients are typically coded as "Asian." It is unknown, however, whether this coarse coding conceals meaningful disparities in the performance of clinical risk scores across granular race groups. Here we show that it does. Using data from 418K emergency department visits, we assess clinical risk score performance disparities across 26 granular groups for three outcomes, five risk scores, and four performance metrics. Across outcomes and metrics, we show that the risk scores exhibit significant granular performance disparities within coarse race groups. In fact, variation in performance within coarse groups often *exceeds* the variation between coarse groups. We explore why these disparities arise, finding that outcome rates, feature distributions, and the relationships between features and outcomes all vary significantly across granular groups. Our results suggest that healthcare providers, hospital systems, and machine learning researchers should strive to collect, release, and use granular race data in place of coarse race data, and that existing analyses may significantly underestimate racial disparities in performance., Comment: Published at MLHC 2023. v2 includes minor changes from the camera-ready, such as a link to code. Code is available at https://github.com/rmovva/granular-race-disparities_MLHC23

Published
2023

5. Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study

Author

Penwill, Nicole Y, Roessler De Angulo, Nadia, Pathak, Priya R, Ja, Clairissa, Elster, Martha J, Hochreiter, Daniela, Newton, Jacqueline M, Wilson, Karen M, and Kaiser, Sunitha V

Subjects
Health Services and Systems, Health Sciences, Behavioral and Social Science, Pediatric, Clinical Research, Health and social care services research, 8.1 Organisation and delivery of services, Generic health relevance, Good Health and Well Being, Adult, COVID-19, Child, Hospitals, Pediatric, Humans, Pandemics, Qualitative Research, SARS-CoV-2, United States, hospitalized, Delivery of health care, Hospitals, community, pediatric, Qualitative research, Child, hospitalized, Hospitals, community, Hospitals, pediatric, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems, Public health
Abstract

BackgroundThe COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the United States, including changes in the care of hospitalized children. The objectives of this study were to identify major changes in healthcare delivery for hospitalized children during the COVID-19 pandemic, identify lessons learned from these changes, and compare and contrast the experiences of children's and community hospitals.MethodsWe purposefully sampled participants from both community and children's hospitals serving pediatric patients in the six U.S. states with the highest COVID-19 hospitalization rates at the onset of the pandemic. We recruited 2-3 participants from each hospital (mix of administrators, front-line physicians, nurses, and parents/caregivers) for semi-structured interviews. We analyzed interview data using constant comparative methods to identify major themes.ResultsWe interviewed 30 participants from 12 hospitals. Participants described how leaders rapidly developed new hospital policies (e.g., directing use of personal protective equipment) and how this was facilitated by reviewing internal and external data frequently and engaging all relevant stakeholders. Hospital leaders optimized communication through regular, transparent, multi-modal, and bi-directional communication. Clinicians increased use of videoconference and telehealth to facilitate physical distancing, but these technologies may have disadvantaged non-English speakers. Due to declining volumes of hospitalized children and surges of adult patients, clinicians newly provided care for hospitalized adults. This was facilitated by developing care teams supported by adult hospitalists, multidisciplinary support via videoconference, and educational resources. Participants described how the pandemic negatively impacted clinicians' mental health, and they stressed the importance of mental health resources and wellness activities/spaces.ConclusionsWe identified several major changes in inpatient pediatric care delivery during the COVID-19 pandemic, including the adoption of new hospital policies, video communication, staffing models, education strategies, and staff mental health supports. We outline important lessons learned, including strategies for successfully developing new policies, effectively communicating with staff, and supporting clinicians' expanding scope of practice. Potentially important focus areas in pandemic recovery include assessing and supporting clinicians' mental health and well-being, re-evaluating trainees' skills/competencies, and adapting educational strategies as needed. These findings can help guide hospital leaders in supporting pandemic recovery and addressing future crises.

Published
2021

6. Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries: JACC International

Author

Pathni, Anupam, Osi, Kufor, Dessie, Girma, Zhang, Xiulei, Cazabon, Danielle, Banigbe, Bolanle, Farrell, Margaret, Erojikwe, Okeoma, Swahoo, Swagata, Krishna, Ashish, Yusuf, Abdikaid Ahmed, Kebede, Henok Gebreyohannes, Berhanu, Molla Gedefaw, Bezabih, Tilahun, Tegegn, Teshome Ayalew, Demissie, Workneh, Burka, Daniel, Tasmin, Misu, Ogbeide, Bolatito, Cheadle, Timothy, Odu, Joseph, Beyene, Meron Hailu, Borkhataria, Cecile, Elliott, Kate, Jaffe, Marc, Garg, Renu, Frieden, Thomas R., Khan, Taskeen, Slama, Slim, Mikkelson, Bente, Lai, Truong Duc, Santos, Rauell John, Aquino, Tyrone, Calla, Dofel Joseph, Kunwar, Abhishek, Durgad, Kiran, Bunluesin, Sushera, Dewan, Mary, Obagha, C.E., Msyamboza, Kelias, Das, Bidisha, Kishore, Navneet, Puthussery, Yannick Poulose, Sambandam, Gopinath Thirugnana, Immanuel, A Branch, Chandrakant Joshi, Chakshu, Bhardawaj, Rupali, Wankhede, Amol, Khedkar, Suhas Namdevrao, Bhardawaj, Vishwajit Washudeorao, Kumar Reddy, Thokala Sravan, Chavan, Tejpalsinh Anandrao, Chittimella, Raghavendra Patel, Bhandari, Subhasis, Shah, Urvin Kumar, Chandram, Deenadayalan, Wassey, Mohammed Abdul, Kadia, Abhinav, Sarode, Lalit Dinkar, Chauhan, Lalita, Ponna, Satyendra Nath, Babu, Suresh, Gupta, Piyush, Reddy, Thej Kiran, Sekhon, Hanspreet, Jeelani, Asif, Nath, Gunjan, Wankhede, Virendra, Jayaprasad, Niniya, Mohanty, Trishna, Kumar, Praveen, Khanna, Abhishek, Singh, Shweta, Bhat, Ashish, Thakkar, Jatin, Anitha Sreekumar, Aiswarya Lakshmi, Lakshmanasamy, Ravivarman, Rafique, Mohamed Essa, Dar, Sunil Kumar, Chintala, Sreedhar, Jagadeesh, Bharath, Patruni, Manoj, Raimule, Madhur, Prabhu Valawalkar, Shahanara S., Ordunez, Pedro, Giraldo, Gloria, Martinez, Ramon, Rosende, Andres, Rodriguez, Yenny, Lombardi, Cintia, Gamarra, Angelo, Rodriguez, Libardo, Parra, Natalia, Rodriguez, Gonzalo, Villalta, Noelia, Escobar, Maria C., Villacres, Nilda, Sorto, Carlos, Baca, Edith, Batista, Vhania, Perez, Vivian, Victoria, Jorge, Abaakouk, Zohra, Malcolm, Taraleen, Kostova, Deliana, Richter, Patricia, Whelton, Paul K., Lackland, Daniel, Weber, Michael, Pineiro, Daniel, Wood, David, Pinto, Fausto, Mwangi, Jeremiah, Perel, Pablo, Codato, Elisa, Eiselé, Jean-Luc, Kaur, Prabhdeep, Parashuraman, Ganeshkumar, Sharma, Meenakshi, Shivashankar, Roopa, Bangar, Sampada Dipak, Chakma, Tapas, Pragya, Pragati, Malik, Abdul, Awal, Khondker Abdul, Malik, Fazilatunnesa, Choudhury, Sohel Reza, Bhuiyan, Mahfuzur Rahman, Jubayer, Shamim, Al Mamun, Mohammad Abdullah, Ishraquzzaman, Mir, Abrar, Ahmed Khairul, Akhter, Jubaida, Sultana, Sarmin, Parvej, Aslam, Sayem Khandoker Ehsanul Amin, Noor Nabi, Islam, Md Shahinul, Dey Parag, Deb Dulal, Amin, Ruhul, Luna, Mahfuja, Ibn Karim, Md Abbas, Mahajabin, Progga, Khan, Iqbal Ahmed, Hossain, Sazzad, Ullah, Riasat Razi, Nahid, Muhtamim Fuwad, Zhang, Xinhua, Huang, Hongxia, Wang, Hao, Guan, Tingrui, Zhao, Haiying, Ojji, Dike, Shedul, Gabriel Lamkur, Shedul, Grace, Orji, Anthony, Asuku, Regina, Alo-Joseph, Confidence, Akor, Charity, Egenti, Nonye, Nwankwo, Ada, Omitiran, Kasarachi, Okoli, Rosemary, Ripiye, Nanna, Akor, Blessing, Cai, Jun, Wang, Lu, Wang, Wenjie, Fan, Luyun, Xu, Jianrong (Jenny), Tang, Shanshan, Wu, Guoli, Smith, Barbara, Kenyon, Thomas, Mandal, Sudarsan, Swarnakar, Sunny, Wickramasinghe, S.C., Herath, Amila Bandarra, Ratnayake, I.U., Samarasinghe, Kosala, Kumarasiri, K.H.N., Vensentini, Natalia, Mendieta, Daniel Palacios, Rivera, Marcela, Gonzalez, Yamile Valdez, Cevallos, Lucia, Villatoro, Matías Humberto, Gloria Hernandez, Laura Elena, Arenas, Elsa, Fernández, Daniel, De Oleo, Daniel Mola, Cyr, Shana, Mitchell, Roxanne, Hossain, AHM Enayet, Amin, Mohammad Robed, Alim, Abdul, Milon, Sarowar Uddin, Alex-Okoh, M.O., Odoh-Bako, D.O., Malau, M.T., Oshundele, B.R., Akinkoye, O.K., Abraham, E.A., Eze, S.V., Elemuwa, Chris, Lamorde, Suleiman, Oguntayo, E.A., Rajab, Ashiru, Ibrahim, Auwalu, Soyinka, Festus, Caluag, Maria Elizabeth, Uy, Maria Rosario, Adriano Subaan, Regional Director, Gayomali, Aimee Marie, Lapascua, John Richard, Taffese, Hiwot Solomon, Bac, Truong Dinh, Bao, Tran Quoc, Guo, Xiaolei, Xu, Chunxiao, Zhang, Bingyin, Thi Tho, Nguyen Thi, Van, Ngo Hai, Danh, Phan Cong, Tinh, Ho Huu, Hau, Tran Phuc, Appel, Lawrence J., Matsushita, Kunihiro, Andersen, Katye, Ayensu-Asiedu, Christabelle, Byiringiro, Samuel, Brady, Tammy, Charleston, Jeanne, Chen, Mengkun, Commodore–Mensah, Yvonne, Dalcin, Arlene, Dennison-Himmelfarb, Cheryl, Ding, Ning, Doyle, Christopher K., Edward, Anbrasi, de Souza Elias, Sabrina, Foti, Kathryn, Greer, Raquel, Henry, Megan, Hu, Xiao, Ishigami, Junichi, Kou, Minghao, Lord, Katherine, Lu, Yifei, Marklund, Matti, Amezcua, Pablo Martinez, Mattingly, Joey, McArthur, Kristin, Miller, Edgar R., III, Neupane, Dinesh, Ogungbe, Bunmi, Pariyo, George, Pathak, Priya, Pilla, Scott, Rao, Krishna, Resnick, Carol, Riekert, Kristin, Sakulsaengprapha, Tangkwa, Scheiber, Simona, Shilkofski, Nicole, Tamplin, Steve, Tang, Olive, Zhao, Di, Campbell, Norman, Ogedegbe, Olugbenga, Di Pette, Donald, Brettler, Jeffrey, Connell, Kenneth, Kishore, Sandeep P., Huffman, Mark, Hutchinson, Brian, Abdalla, Marwa, Moran, Andrew E., and Gupta, Reena

Published
2023
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10. Access to primary care telemedicine and visit characterization in a pediatric low-income, primarily Latino population: A retrospective study (Preprint)

Author

Pathak, Priya R, primary, Stockwell, Melissa S, additional, Lane, Mariellen M, additional, Robbins-Milne, Laura, additional, Friedman, Suzanne, additional, Pethe, Kalpana, additional, Krause, Margaret C, additional, Soren, Karen, additional, Matiz, Luz Adriana, additional, Solomon, Lauren B, additional, and Bracho-Sanchez, Edith, additional

Published
2024
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13. Variation in outcomes and practice patterns among patients with localized pancreatic cancer: the impact of the pancreatic cancer multidisciplinary clinic.

Author

Pathak, Priya, Hacker-Prietz, Amy, Herman, Joseph M., Lei Zheng, Jin He, and Narang, Amol K.

Subjects
PATIENT compliance, PANCREATIC cancer, NEOADJUVANT chemotherapy, ONCOLOGIC surgery, OVERALL survival
Abstract

Introduction: Patients with localized pancreatic adenocarcinoma (PDAC) benefit from multi-modality therapy. Whether care patterns and oncologic outcomes vary if a patient was seen through a pancreatic multi-disciplinary clinic (PMDC) versus only individual specialty clinics is unclear. Methods: Using institutional Pancreatic Cancer Registry, we identified patients with localized PDAC from 2019-2022 who eventually underwent resection. It was our standard practice for borderline resectable (BRPC) patients to undergo =4 months of neoadjuvant chemotherapy, ± radiation, followed by exploration, while locally advanced (LAPC) patients were treated with 4-6 months of chemotherapy, followed by radiation and potential exploration. Descriptive and multivariable analyses (MVA) were performed to examine the association between clinic type (PMDC vs individual specialty clinics i.e. surgical oncology, medical oncology, or radiation oncology) and study outcomes. Results: A total of 416 patients met inclusion criteria. Of these, 267 (64.2%) had PMDC visits. PMDC group received radiation therapy more commonly (53.9% versus 27.5%, p=0.001), as compared to individual specialty clinic group. Completion of neoadjuvant treatment (NAT) was far more frequent in patients seen through PMDC compared to patients seen through individual specialty clinics (69.3% vs 48.9%). On MVA, PMDC group was significantly associated with receipt of NAT per institutional standards (adjusted OR 2.23, 95% CI 1.46-7.07, p=0.006). Moreover, the average treatment effect of PMDC on progression-free survival (PFS) was 4.45 (95CI: 0.87-8.03) months. No significant association between overall survival (OS) and clinic type was observed. Discussion: Provision of care through PMDC was associated with significantly higher odds of completing NAT per institutional standards as compared to individual specialty clinics, which possibly translated into improved PFS. The development of multidisciplinary clinics for management of pancreatic cancer should be incentivized, and any barriers to such development should be addressed. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Effects of Trichoderma viride and Aspergillus on the growth and Nutritions of Pleurotus ostreatus

Author

Singh, Chandan, Chaudhary, Neelam, Pathak, Priya, Apeksha Rathi, Daheriya, Poonam, and Vyas, Deepak

Subjects
Dietary fiber, Protein, Trichoderma sp, Pleurotus ostreatus
Abstract

It is evident that the Oyster mushroom readily enjoys wheat straw as a better substrate in comparison to the other substrates used for cultivation. The present study conducted to check the nutritional status of the the Oyster mushroom harvested from the bag contaminated by the Trichoderma viride. The result showed the unexpected and unusual positive role of Trichoderma viride for the growth of Pleurotus ostreatus and biochemical changes in the test mushroom. This is justified by the biochemical analysis ofmushroom fruiting bodies harvested from the bags contaminated by the T.viride and mushroom fruiting bodies harvested from the non-contaminated bags.The analytical result showed a lowering of glucose and sucrose concentration where protein and total dietary fibre was found to be increased; moreover, fructose and total fat have also increased when compared to mushrooms harvested from non-contaminated bags.

Published
2022
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33. Indurated dusky red swelling on the forearm of an infant: Tufted angioma

Author

Jakhar, Deepak, Singal, Archana, Kaur, Ishmeet, and Pathak, Priya

Subjects
Pediatric tumors -- Diagnosis -- Case studies, Tumors, Genetic disorders, Immunohistochemistry, Hyperhidrosis, Health
Abstract

Byline: Deepak. Jakhar, Archana. Singal, Ishmeet. kaur, Priya. Pathak Tufted angioma (TA) is a rare benign vascular tumor that may be congenital or acquired and generally presents as an asymptomatic [...]

Published
2019

39. Acute appendicitis secondary to Entamoeba histolytica infestation.

Author

Patel, Surbhi J., Pathak, Priya, Thejeswi, Poornachandra, and Bandari, Manisha

Subjects
*ENTAMOEBA histolytica, *APPENDICITIS, *TROPHOZOITES
Abstract

Acute appendicitis secondary to amoebic infestation is a rare possibility, especially in endemic areas. If left untreated, significant postoperative morbidity and mortality can result from the spread of amoebic trophozoites and subsequent tissue reaction. Histopathological examination of the resected appendix with demonstration of invasion by the parasite is mandatory for establishing a diagnosis. Careful examination of the specimen is thus of paramount importance. [ABSTRACT FROM AUTHOR]

Published
2023
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