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About Mayo Clinic's Kern Center for the Science of Health Care Delivery
Mayo Clinic's Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery seeks to discover new ways to improve health; translate those discoveries into evidence-based, actionable treatments, processes and procedures; and apply this new knowledge to improve care for patients everywhere. Learn more about the research center.
About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. For information on COVID-19, including Mayo Clinic's Coronavirus Map tracking tool, which has 14-day forecasting on COVID-19 trends, visit the Mayo Clinic COVID-19 Resource Center.
Trial demonstrates early AI-guided detection of heart disease in routine practice
2021-05-06
(Press-News.org) ROCHESTER, Minn. ? Heart disease can take a number of forms, but some types of heart disease, such as asymptomatic low ejection fraction, can be hard to recognize, especially in the early stages when treatment would be most effective. The ECG AI-Guided Screening for Low Ejection Fraction, or EAGLE, trial set out to determine whether an artificial intelligence (AI) screening tool developed to detect low ejection fraction using data from an EKG could improve the diagnosis of this condition in routine practice. Study findings are published in Nature Medicine.
Systolic low ejection fraction is defined as the heart's inability to contract strongly enough with each beat to pump at least 50% of the blood from its chamber. An echocardiogram can readily diagnose low ejection fraction, but this time-consuming imaging test requires more resources than a 12-lead EKG, which is fast, inexpensive and readily available. The AI-enabled EKG algorithm was tested and developed through a convolutional neural network and validated in subsequent studies.
The EAGLE trial took place in 45 medical institutions in Minnesota and Wisconsin, including rural clinics, and community and academic medical centers. In all, 348 primary care clinicians from 120 medical care teams were randomly assigned to usual care or intervention. The intervention group was alerted to a positive screening result for low ejection fraction via the electronic health record, prompting them to order an echocardiogram to confirm.
"The AI-enabled EKG facilitated the diagnosis of patients with low ejection fraction in a real-world setting by identifying people who previously would have slipped through the cracks," says Peter Noseworthy, M.D., a Mayo Clinic cardiac electrophysiologist. Dr. Noseworthy is senior author on the study.
In eight months, 22,641 adult patients had an EKG under the care of the clinicians in the trial. The AI found positive results in 6% of the patients. The proportion of patients who received an echocardiogram was similar overall, but among patients with a positive screening result, a higher percentage of intervention patients received an echocardiogram.
"The AI intervention increased the diagnosis of low ejection fraction overall by 32% relative to usual care. Among patients with a positive AI result, the relative increase of diagnosis was 43%," says Xiaoxi Yao, Ph.D., a health outcomes researcher in cardiovascular diseases at Mayo Clinic and first author on the study. "To put it in absolute terms, for every 1,000 patients screened, the AI screening yielded five new diagnoses of low ejection fraction over usual care."
"With EAGLE, the information was readily available in the electronic health record, and care teams could see the results and decide how to use that information," says Dr. Noseworthy. "The takeaway is that we are likely to see more AI use in the practice of medicine as time goes on. It's up to us to figure how to use this in a way that improves care and health outcomes but does not overburden front-line clinicians."
Also, the EAGLE trial used a positive deviance approach to evaluate the top five care team users and the top five nonusers of the AI screening information. Dr. Yao says this cycle of learning and feedback from physicians will demonstrate ways of improving adaptation and application of AI technology in the practice.
EAGLE is one of the first large-scale trials to demonstrate value of AI in routine practice. The low ejection fraction algorithm, which has received Food and Drug Administration breakthrough designation, is one of several algorithms developed by Mayo and licensed to Anumana Inc., a new company focusing on unlocking hidden biomedical knowledge to enable early detection as well as accelerate treatment of heart disease. The low ejection fraction algorithm was also previously licensed to Eko Devices Inc., specifically for hand-held devices that are externally applied to the chest.
The EAGLE trial was funded by Mayo Clinic's Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, in collaboration with the departments of Cardiovascular Medicine and Family Medicine, and the Division of Community Internal Medicine.
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JAMA Health Forum now peer-reviewed journal
2021-05-06
What The Editorial Says: JAMA Health Forum debuts this week as a peer-reviewed, open-access, online journal focused on health policy, health care systems, and global and public health. The journal has transitioned from an online health policy channel and is the newest member of the family of JAMA Network specialty journals. The editor of JAMA Health Forum is John Z. Ayanian, M.D., M.P.P., of the University of Michigan in Ann Arbor, and the deputy editor is Melinda B. Buntin, Ph.D., of the Vanderbilt University School of Medicine in Nashville, Tennessee.
Authors: John Z. Ayanian, M.D., M.P.P., of the University of Michigan in Ann Arbor, is the corresponding author.
To access the embargoed study: Visit our For The Media website at ...
Health care use after COVID-19 diagnosis, home monitoring
2021-05-06
What The Study Did: Researchers compared health care use among patients with COVID-19 who were enrolled in a home monitoring program with similar patients who were not enrolled.
Authors: Anita D. Misra-Hebert, M.D., M.P.H., of the Cleveland Clinic, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamahealthforum.2021.0333)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
INFORMATION:
Media advisory: The full study and editor's ...
Researchers identify cause and drug targets for bewildering rare children's disease
2021-05-06
New York, NY (May 6, 2021) -- Researchers have finally cracked the code of a bewildering pediatric disease that sets off a characteristic cytokine storm--a harmful immune system overaction resembling one that arises in COVID-19 cases--and can lead to catastrophic multisystem organ failure or neurodegeneration. Their study, which identifies the cause of the cytokine storm and possible treatments, was published in Nature Medicine in May.
The mystery of this disease, Langerhans-cell histiocytosis (LCH), runs deep. Its symptoms vary widely, and LCH has the ability to infiltrate almost any organ system, leaving most patients with long-term ...
Molecular analysis identifies key differences in lungs of cystic fibrosis patients
2021-05-06
A team of researchers from UCLA, Cedars-Sinai and the Cystic Fibrosis Foundation has developed a first-of-its-kind molecular catalog of cells in healthy lungs and the lungs of people with cystic fibrosis.
The catalog, described today in the journal Nature Medicine, reveals new subtypes of cells and illustrates how the disease changes the cellular makeup of the airways. The findings could help scientists in their search for specific cell types that represent prime targets for genetic and cell therapies for cystic fibrosis.
"This new research has provided us with valuable insights into the cellular makeup of both healthy and diseased airways," said Dr. Brigitte Gomperts, a co-senior author of the study and a member of the Eli and Edythe Broad Center of Regenerative ...
Obesity may be a more significant risk factor for death from COVID-19 for men than women
2021-05-06
Obesity may be a stronger risk factor for death, severe pneumonia and the need for intubation in men than in women with COVID-19, according to a study published in the European Journal of Clinical Microbiology & Infectious Diseases.
An analysis of a cohort of 3530 COVID-19 patients showed that both moderate (BMI of 35/m2 or higher) and severe obesity (BMI of 40kg/m2 and higher) in men but only severe obesity in women (BMI of 40kg/m2 and higher) was associated greater risk of developing severe disease, needing intubation and dying from COVID-19 in hospital.
Previous research demonstrated that obesity is a risk factor for hospitalization, severe disease, and death in patients with COVID-19. ...
Bacterial DNA can be read either forwards or backwards - new study
2021-05-06
Bacteria contain symmetry in their DNA signals that enable them to be read either forwards or backwards, according to new findings at the University of Birmingham which challenge existing knowledge about gene transcription.
In all living organisms, DNA code is divided into sections which provide information about a specific process. These must be read before the information can be used. Cells identify the start of each section using 'signposts', which scientists first identified in the 1960s.
It has always been assumed that these signposts enable genetic sequences ...
Independent evolutionary origins of vertebrate dentitions, according to latest study
2021-05-06
The origins of a pretty smile have long been sought in the fearsome jaws of living sharks which have been considered living fossils reflecting the ancestral condition for vertebrate tooth development and inference of its evolution. However, this view ignores real fossils which more accurately reflect the nature of ancient ancestors.
New research led by the University of Bristol and the Naturalis Biodiversity Center published in Nature Ecology and Evolution reveals that the dentitions of living shark relatives are entirely unrepresentative of the last shared ancestor of jawed vertebrates.
The study reveals ...
Association between vaccination with Pfizer-BioNTech BNT162b2, incidence of SARS-CoV-2 infections among health care workers
2021-05-06
What The Study Did: This study estimates the association between Pfizer-BioNTech BNT162b2 vaccination and symptomatic and asymptomatic SARS-CoV-2 infections among health care workers more than seven days after getting a second vaccine dose.
Authors: Ronen Ben-Ami, M.D., of the Tel Aviv Sourasky Medical Center in Israel, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2021.7152)
Editor's Note: The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
INFORMATION:
Media advisory: The full study ...
SARS-CoV-2 infections after Pfizer-BioNTech BNT162b2 vaccination in routinely screened workforce
2021-05-06
What The Study Did: This study describes an association between the Pfizer-BioNTech BNT162b2 vaccine and decreased risk of symptomatic and asymptomatic infections with SARS-CoV-2 in hospital employees.
Authors: Li Tang, Ph.D., of the St. Jude Children's Research Hospital in Memphis, Tennessee, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2021.6564)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest ...
Temperature explains why aquatic life more diverse near equator
2021-05-06
The bulging, equator-belted midsection of Earth currently teems with a greater diversity of life than anywhere else -- a biodiversity that generally wanes when moving from the tropics to the mid-latitudes and the mid-latitudes to the poles.
As well-accepted as that gradient is, though, ecologists continue to grapple with the primary reasons for it. New research from the University of Nebraska-Lincoln, Yale University and Stanford University suggests that temperature can largely explain why the greatest variety of aquatic life resides in the tropics -- but also why it has not ...