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RISS 인기검색어
- 검색키워드
- 저자 : Patrick B. Ryan (검색결과 3 건)
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Characterizing treatment pathways at scale using the OHDSI network
Hripcsak, George,Ryan, Patrick B.,Duke, Jon D.,Shah, Nigam H.,Park, Rae Woong,Huser, Vojtech,Suchard, Marc A.,Schuemie, Martijn J.,DeFalco, Frank J.,Perotte, Adler,Banda, Juan M.,Reich, Christian G.,S National Academy of Sciences 2016 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.113 No.27
<P>Observational research promises to complement experimental research by providing large, diverse populations that would be infeasible for an experiment. Observational research can test its own clinical hypotheses, and observational studies also can contribute to the design of experiments and inform the generalizability of experimental research. Understanding the diversity of populations and the variance in care is one component. In this study, the Observational Health Data Sciences and Informatics (OHDSI) collaboration created an international data network with 11 data sources from four countries, including electronic health records and administrative claims data on 250 million patients. All data were mapped to common data standards, patient privacy was maintained by using a distributed model, and results were aggregated centrally. Treatment pathways were elucidated for type 2 diabetes mellitus, hypertension, and depression. The pathways revealed that the world is moving toward more consistent therapy over time across diseases and across locations, but significant heterogeneity remains among sources, pointing to challenges in generalizing clinical trial results. Diabetes favored a single first-line medication, metformin, to a much greater extent than hypertension or depression. About 10% of diabetes and depression patients and almost 25% of hypertension patients followed a treatment pathway that was unique within the cohort. Aside from factors such as sample size and underlying population (academic medical center versus general population), electronic health records data and administrative claims data revealed similar results. Large-scale international observational research is feasible.</P>
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Highly selective trace ammonium removal from dairy wastewater streams by aluminosilicate materials
Elaine O’Connor,Oisin N. Kavanagh,Drahomir Chovan,David G. Madden,Patrick Cronin,Ahmad B. Albadarin,Gavin M. Walker,Alan Ryan 한국공업화학회 2020 Journal of Industrial and Engineering Chemistry Vol.86 No.-
Water is a key solvent, fundamental to supporting life on earth. It is equally important in many industrialprocesses, particularly within agricultural and pharmaceutical industries, which are major drivers of theglobal economy. The results of water contamination by common activity in these industries is well knownand EU Water Quality Directives and Associated Regulations mandate that NH4+ concentrations ineffluent streams should not exceed 0.3 mg L 1, this has put immense pressure on organisations andindividuals operating in these industries. As the environmental andfinancial costs associated with waterpurification begin to mount, there is a great need for novel processes and materials (particularlyrenewable) to transform the industry. Current solutions have evolved from combating toxic sludge to theuse of membrane technology, but it is well known that the production of these membrane technologiescreates a large environmental footprint. Zeolites could provide an answer; their pore size and chemistryenable efficient removal of aqueous based cations via simple ion exchange processes. Herein, wedemonstrate efficient removal of NH4+ via both static and dynamic methodology for industrialapplication. Molecular modelling was used to determine the cation–framework interactions which willenable customisation and design of superior sorbents for NH4+ capture in wastewater.
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Seng Chan You,Sungjae Jung,Joel N. Swerdel,Patrick B. Ryan,Martijn J. Schuemie,Marc A. Suchard,Seongwon Lee,Jaehyeong Cho,George Hripcsak,Rae Woong Park,Sungha Park 대한심장학회 2020 Korean Circulation Journal Vol.50 No.1
Background and Objectives: 2018 ESC/ESH Hypertension guideline recommends 2-drug combination as initial anti-hypertensive therapy. However, real-world evidence for effectiveness of recommended regimens remains limited. We aimed to compare the effectiveness of first-line anti-hypertensive treatment combining 2 out of the following classes: angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor blocker (A), calcium channel blocker (C), and thiazide-type diuretics (D). Methods: Treatment-naïve hypertensive adults without cardiovascular disease (CVD) who initiated dual anti-hypertensive medications were identified in 5 databases from US and Korea. The patients were matched for each comparison set by large-scale propensity score matching. Primary endpoint was all-cause mortality. Myocardial infarction, heart failure, stroke, and major adverse cardiac and cerebrovascular events as a composite outcome comprised the secondary measure. Results: A total of 987,983 patients met the eligibility criteria. After matching, 222,686, 32,344, and 38,513 patients were allocated to A+C vs. A+D, C+D vs. A+C, and C+D vs. A+D comparison, respectively. There was no significant difference in the mortality during total of 1,806,077 person-years: A+C vs. A+D (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.97−1.20; p=0.127), C+D vs. A+C (HR, 0.93; 95% CI, 0.87−1.01; p=0.067), and C+D vs. A+D (HR, 1.18; 95% CI, 0.95−1.47; p=0.104). A+C was associated with a slightly higher risk of heart failure (HR, 1.09; 95% CI, 1.01−1.18; p=0.040) and stroke (HR, 1.08; 95% CI, 1.01−1.17; p=0.040) than A+D. Conclusions: There was no significant difference in mortality among A+C, A+D, and C+D combination treatment in patients without previous CVD. This finding was consistent across multi-national heterogeneous cohorts in real-world practice.
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