Background: Venous thromboembolism (VTE) is a common complication seen during or after hospitalization that manifests as deep venous thrombosis (DVT) and/or pulmonary embolism (PE). PE is considered the commonest prev...Background: Venous thromboembolism (VTE) is a common complication seen during or after hospitalization that manifests as deep venous thrombosis (DVT) and/or pulmonary embolism (PE). PE is considered the commonest preventable cause of death during and/or after hospitalization. Thus, pharmacological and mechanical methods are used to prevent VTE in hospitalized patients. Despite the availability of guidelines for VTE prophylaxis, it is crucial to assess the adherence and adaptation of the institution to these guidelines. Purpose: This study aimed to investigate adherence to the American College of Chest Physicians (ACCP) 2012 VTE prophylaxis guidelines in hospitalized medical patients in a tertiary care hospital in the United Arab Emirates. Methods: An observational prospective design was utilized in this study. To achieve the purpose, primary and secondary end points were identified to be the core of the investigation. The primary end points were: the incidence of bleeding, VTE, and cardiovascular events. While the secondary end points were: dose and indication validity for prophylaxis, VTE and bleeding risk assessments, adverse drug events (ADE) other than bleeding, appropriate monitoring when on low molecular weight heparin (LMWH) and the presence of contraindication at the time of prescribing LMWH. Results: 16 patients (20%) out of the total 80 met one or more of the primary end points. The vast majority of patients (81.25%) developed bleeding, while VTE was seen in one case only during hospitalization. 11 patients (13.75%) received LMWH while a contraindication was present. 15 patients (18.75%) who were prescribed LMWH had an International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) bleeding risk score of ≥7. However, 5 out of 13 patients (38.46%) who developed bleeding had a bleeding score of ≥7, and the relationship between bleeding score of ≥7 and the development of bleeding was statistically significant (p = 0.047). When investigating the doses that were utilized, 40% were prescribed an inappropriate dose. Conclusion: Various factors played a role in the inappropriateness of VTE prophylaxis such as;poor adherence to VTE guidelines, inappropriate dosing and monitoring, and not evaluating the bleeding risk. Hence, to be able to achieve effective VTE prophylaxis, these factors need to be addressed through adherence to and adaptation of the ACCP 2012 VTE prophylaxis guidelines.展开更多
分类问题是数据研发领域里研究和使用最广泛的技术之一。近几年经济的飞速发展,分类问题在多行业和领域中被广泛使用,那么,怎样更准确、更有效地分类呢?这是多数研究工作人员的目标。决策树(decision tree)以条理清晰,程序严谨,定量、...分类问题是数据研发领域里研究和使用最广泛的技术之一。近几年经济的飞速发展,分类问题在多行业和领域中被广泛使用,那么,怎样更准确、更有效地分类呢?这是多数研究工作人员的目标。决策树(decision tree)以条理清晰,程序严谨,定量、定性分析相结合,方法通俗易懂,容易掌握,应用性较强等优点,被广泛应用。现在构造决策树的算法比较多,如:ID3算法、C4.5算法、CART等。C4.5算法是在ID3算法的基础上进行改进的,C4.5算法选用信息增益率(Info Gain Ratio)为择取分枝属性的标准,此方法弥补了ID3算法在运用信息增益择取分枝属性时偏向于取值较多的属性的不足之处,但是C4.5算法也有部分缺陷,本文主要在其处理连续属性比较耗时问题上进行深入探讨,本文对其连续的处理过程进行改进来提高C4.5算法的计算效率,大大缩短算法用时。展开更多
文摘Background: Venous thromboembolism (VTE) is a common complication seen during or after hospitalization that manifests as deep venous thrombosis (DVT) and/or pulmonary embolism (PE). PE is considered the commonest preventable cause of death during and/or after hospitalization. Thus, pharmacological and mechanical methods are used to prevent VTE in hospitalized patients. Despite the availability of guidelines for VTE prophylaxis, it is crucial to assess the adherence and adaptation of the institution to these guidelines. Purpose: This study aimed to investigate adherence to the American College of Chest Physicians (ACCP) 2012 VTE prophylaxis guidelines in hospitalized medical patients in a tertiary care hospital in the United Arab Emirates. Methods: An observational prospective design was utilized in this study. To achieve the purpose, primary and secondary end points were identified to be the core of the investigation. The primary end points were: the incidence of bleeding, VTE, and cardiovascular events. While the secondary end points were: dose and indication validity for prophylaxis, VTE and bleeding risk assessments, adverse drug events (ADE) other than bleeding, appropriate monitoring when on low molecular weight heparin (LMWH) and the presence of contraindication at the time of prescribing LMWH. Results: 16 patients (20%) out of the total 80 met one or more of the primary end points. The vast majority of patients (81.25%) developed bleeding, while VTE was seen in one case only during hospitalization. 11 patients (13.75%) received LMWH while a contraindication was present. 15 patients (18.75%) who were prescribed LMWH had an International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) bleeding risk score of ≥7. However, 5 out of 13 patients (38.46%) who developed bleeding had a bleeding score of ≥7, and the relationship between bleeding score of ≥7 and the development of bleeding was statistically significant (p = 0.047). When investigating the doses that were utilized, 40% were prescribed an inappropriate dose. Conclusion: Various factors played a role in the inappropriateness of VTE prophylaxis such as;poor adherence to VTE guidelines, inappropriate dosing and monitoring, and not evaluating the bleeding risk. Hence, to be able to achieve effective VTE prophylaxis, these factors need to be addressed through adherence to and adaptation of the ACCP 2012 VTE prophylaxis guidelines.
文摘分类问题是数据研发领域里研究和使用最广泛的技术之一。近几年经济的飞速发展,分类问题在多行业和领域中被广泛使用,那么,怎样更准确、更有效地分类呢?这是多数研究工作人员的目标。决策树(decision tree)以条理清晰,程序严谨,定量、定性分析相结合,方法通俗易懂,容易掌握,应用性较强等优点,被广泛应用。现在构造决策树的算法比较多,如:ID3算法、C4.5算法、CART等。C4.5算法是在ID3算法的基础上进行改进的,C4.5算法选用信息增益率(Info Gain Ratio)为择取分枝属性的标准,此方法弥补了ID3算法在运用信息增益择取分枝属性时偏向于取值较多的属性的不足之处,但是C4.5算法也有部分缺陷,本文主要在其处理连续属性比较耗时问题上进行深入探讨,本文对其连续的处理过程进行改进来提高C4.5算法的计算效率,大大缩短算法用时。
