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2. Patient Outcome Predictions Improve Operations at a Large Hospital Network

Author

Na, Liangyuan, Carballo, Kimberly Villalobos, Pauphilet, Jean, Haddad-Sisakht, Ali, Kombert, Daniel, Boisjoli-Langlois, Melissa, Castiglione, Andrew, Khalifa, Maram, Hebbal, Pooja, Stein, Barry, and Bertsimas, Dimitris

Subjects
Computer Science - Machine Learning, Computer Science - Artificial Intelligence
Abstract

Problem definition: Access to accurate predictions of patients' outcomes can enhance medical staff's decision-making, which ultimately benefits all stakeholders in the hospitals. A large hospital network in the US has been collaborating with academics and consultants to predict short-term and long-term outcomes for all inpatients across their seven hospitals. Methodology/results: We develop machine learning models that predict the probabilities of next 24-hr/48-hr discharge and intensive care unit transfers, end-of-stay mortality and discharge dispositions. All models achieve high out-of-sample AUC (75.7%-92.5%) and are well calibrated. In addition, combining 48-hr discharge predictions with doctors' predictions simultaneously enables more patient discharges (10%-28.7%) and fewer 7-day/30-day readmissions ($p$-value $<0.001$). We implement an automated pipeline that extracts data and updates predictions every morning, as well as user-friendly software and a color-coded alert system to communicate these patient-level predictions (alongside explanations) to clinical teams. Managerial implications: Since we have been gradually deploying the tool, and training medical staff, over 200 doctors, nurses, and case managers across seven hospitals use it in their daily patient review process. We observe a significant reduction in the average length of stay (0.67 days per patient) following its adoption and anticipate substantial financial benefits (between \$55 and \$72 million annually) for the healthcare system., Comment: 41 pages, 13 figures

Published
2023

6. The evolving value assessment of cancer therapies: Results from a modified Delphi study

Author

Lee, Myrto, Larose, Hugo, Gräbeldinger, Martin, Williams, Jon, Baird, Anne-Marie, Brown, Susan, Bruns, Johannes, Clark, Russell, Cortes, Javier, Curigliano, Giuseppe, Ferris, Andrea, Garrison, Louis P., Gupta, Y.K., Kanesvaran, Ravindran, Lyman, Gary, Pani, Luca, Pemberton-Whiteley, Zack, Salmonson, Tomas, Sawicki, Peter, Stein, Barry, Suh, Dong-Churl, Velikova, Galina, and Grueger, Jens

Published
2024
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12. Moving beyond Assessment to Improving Students' Critical Thinking Skills: A Model for Implementing Change

Author

Haynes, Ada, Lisic, Elizabeth, Goltz, Michele, Stein, Barry, and Harris, Kevin

Abstract

This research examines how the use of the CAT (Critical thinking Assessment Test) and involvement in CAT-Apps (CAT Applications within the discipline) training can serve as an important part of a faculty development model that assists faculty in the assessment of students' critical thinking skills and in the development of these skills within their courses. Seventy-five percent of faculty participating in a CAT scoring workshop at their institution reported greater understanding of students' strengths and weaknesses in critical thinking and 45% reported that CAT scoring had changed their teaching practices and/or assessment. In addition, participants attending a training session on CAT-Apps reported a greater willingness to place more emphasis on critical thinking assessments and less on factual knowledge assessments in their courses as a result of participation in training.

Published
2016

26. HTA community perspectives on the use of patient preference information: lessons learned from a survey with members of HTA bodies

Author

Hiligsmann, Mickael, primary, Liden, Barry, additional, Beaudart, Charlotte, additional, Germeni, Evi, additional, Hanna, Alissa, additional, Joshi, Maya, additional, Koola, Catherine P., additional, Stein, Barry, additional, Tonkinson, Mandy, additional, Marshall, Deborah, additional, and Fifer, Simon, additional

Published
2024
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28. A Survey Detailing Early Onset Colorectal Cancer Patient and Caregiver Experiences in Canada.

Author

Auer, Rebecca, Meszaros, Claudia, Fossouo, Lucresse, Vandermeer, Lisa, and Stein, Barry D.

Subjects
COLORECTAL cancer, MEDICAL personnel, CANADIANS, PATIENTS' attitudes, SYMPTOMS
Abstract

The incidence of early onset colorectal cancer (EOCRC) in Canada has increased. To address the growing incidence of EOCRC, Colorectal Cancer Canada (CCC) developed the Never Too Young (N2Y) program to identify gaps in care and evaluate patient and caregiver experiences with CRC. The survey was available online using SurveyMonkey across Canada between 12 December 2022 and 1 May 2023. The patient and caregiver survey consisted of 113 and 94 questions, respectively. A total of 108 EOCRC patients and 20 caregivers completed the survey. Many respondents were unaware of EOCRC (41.6%) and the disease symptoms (45.2%) before diagnosis. Patient age at diagnosis was between 45 and 50 years in 31.7%, and 72.8% of them were diagnosed at stage III or IV. A perception of an initial misdiagnosis was common (67.4%) for EOCRC patients, and 51.2% felt dismissed due to their age. Patients and caregivers reported impacts of EOCRC on their mental health, with 70.9% of patients expressing a need for support with depression and 93.3% of caregivers experiencing a constant fear of recurrence of their loved one's cancer. Improving the Canadian population's awareness of EOCRC (e.g., CRC symptoms) is important for ensuring timely diagnoses. Similarly, it is critical to ensure that healthcare providers are aware of the increase in EOCRC cases and the unique needs of these patients. Re-evaluation of the CRC screening age should be undertaken in Canada to determine whether lowering the start age to 45 years will improve outcomes in this demographic. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Understanding Colorectal Cancer Patient Experiences with Family Practitioners in Canada.

Author

Mksyartinian, Patil, Mohammad, Neha, Wildgoose, Petra, and Stein, Barry D.

Subjects
COLORECTAL cancer, DELAYED diagnosis, PATIENTS' families, OLDER people, MEDICAL screening
Abstract

Despite ongoing screening efforts, colorectal cancer (CRC) remains a leading cause of death in Canada. The aim of this study was to better understand the experiences of Canadian CRC patients with their family practitioners (FPs) during and after their CRC diagnosis. Patient-reported data were collected through an online questionnaire to understand their CRC diagnosis experiences and identify potential gaps in care. Various factors contributing to challenges throughout a patient's CRC diagnosis (e.g., delayed CRC diagnosis) were determined using descriptive, qualitative, and inferential analyses. These factors could be targeted to optimize CRC care. This study found that 40.6% of the 175 respondents were unaware of at least one of the following aspects of CRC prior to their diagnosis: early-age onset (EAO), symptoms, and screening procedures. While 84.6% had access to a family physician (FP) before their diagnosis, only 17.7% were diagnosed by FPs. Higher proportions of younger individuals experienced misdiagnoses and felt dismissed compared to older individuals. Only half felt fully informed about their diagnosis when it was explained to them by their FP, while 53.1% had their diagnosis explained in plain language. Transitioning towards patient-centred care would promote pre-diagnosis CRC awareness, address differences in management of CRC care (e.g., dismissal and support), and accommodate for age and health-literacy-related disparities, thereby improving CRC care pathways for patients. Future research should investigate FPs experiences in detecting CRC cases to develop educational resources and recommendations, enhancing early detection and improving patient outcomes (1). [ABSTRACT FROM AUTHOR]

Published
2024
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36. Annual Reports of Sections and Divisions of The Florida Bar.

Author

Carden, Leenetta, Taner, Tyler J., Koehler, Christopher R., Adams, Jackson Wolfe, Palmer, R. Scott, Gooden, Kansas R., Hall, Tom, Kozlow, Elisabeth, Morgenstein, Charles R., Lesser, Steven B., Freed, Michael, Latorre, Katherine, Feiler, Michael B., Bronson, Ardith M., Davis, Daniel, Murray, G.C., II, Adams, Joseph E., Buncome, Melina, Difranza, Lisa, Ufferman, Michael, McNeill, Jane A., Syprett, Charlie Ann, Adams, Nathan A., IV, Wallace, Heather J., Fanzlaw, Amy J., Pope, Kenneth C., Kairalla, Jason P., Comey, Edward, Goethe, Jeffrey S., High, Cary A., Spangler, Lori M., Black, Gregory K., Squires-Binford, Grey, Bachman, Radha V., Seagrave, Alan, Wasylik, Dineen, Escobar, Annette C., Gray, Tamara Ilene, Posgay, Matthew, Berman, Linda M., Drlicka, Erick M., O'Leary, James L., Hosley, Kimberly, Inkeles, Doreen, Robinson, D. Dwayne Antonio, Parker, Jennifer, Schwait, Carl, Higer, Michael, A'Hearn, Deborah Ann, McEwen, Catherine Peek, McLeroy, Kathleen S., Davis, Kirsten K., Schaefer, John, Braccialarghe, Randolph, Fleitas, Roberto F., III, Gagliardi, Josephine, Stein, Leslie Reicin, Walsh, Maureen B., Long, Brittany Adams, Houck-Toll, Erin E., Saikali, Al, Karmelin, Ira D., McCabe, Susanne, Hodz, Vivian Cortes, Leuchtman, Gary B., and Stein, Barry A.

Subjects
The Florida Bar -- Reports, Annual reports -- Evaluation -- Analysis -- Reports
Abstract

EDITOR'S NOTE: Due to the COVID-19 health crisis, some of the events described below have been rescheduled or cancelled since this issue went to press in early April. Please consult [...]

Published
2020

39. The IDEAL Workplace: Strategies for Improving Learning, Problem Solving, and Creativity.

Author

NashvilleREAD, Nashville, TN., Bransford, John D., Haynes, Ada F., and Stein, Barry S.

Abstract

This manual, which is based on extensive research on cognitive psychology and organizational theory, contains resources for nine workshop sessions designed to help people become creative problem solvers in their workplace and their lives. The materials are based on Bransford and Stein's IDEAL model, according to which successful problem solving entails the following actions: Identify problems that others may have overlooked; Develop at least two sets of contrasting goals for any problem and define them explicitly; Explore strategies and continually evaluate those strategies' relevance to their goals; Anticipate the effects of strategies before acting on them; and examine the effects of their efforts and Learn from them. Topics addressed in the nine modules are as follows: the importance of problem solving; the IDEAL framework; understanding ourselves; enhancing creativity; perfecting the art of learning (this topic is covered in two sessions); assessing what we know; effective communication; and putting it all together. After a note to trainers that explains the principles of the IDEAL model and the trainer's role in helping master problem-solving strategies, the following materials are provided: module overviews and lesson plans; exercises for grammar, vocabulary, writing, and math; student handouts; pretests and posttests, and answer keys to all exercises and tests. (MN)

Published
1998

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