ObjectiveTo assess accuracy of telephone triage in identifying patients who need emergency care a... more ObjectiveTo assess accuracy of telephone triage in identifying patients who need emergency care amongst those with suspected COVID-19 infection and identify factors which affect triage accuracy.DesignObservational cohort studySettingCommunity telephone triage in the Yorkshire and Humber, Bassetlaw, North Lincolnshire and North East Lincolnshire region.Participants40, 261 adults who contacted NHS 111 telephone triage services provided by Yorkshire Ambulance Service NHS Trust between the 18th March 2020 and 29th June 2020 with symptoms indicating possible COVID-19 infection were linked to Office for National Statistics death registration data, hospital and general practice electronic health care data collected by NHS Digital.OutcomeAccuracy of triage disposition (self-care/non-urgent clinical assessment versus ambulance dispatch/urgent clinical assessment) was assessed in terms of death or need for organ support at 30, 7 and 3 days from first contact with the telephone triage service....
Introduction. The aim of this paper is to identify and characterize the routes by which research ... more Introduction. The aim of this paper is to identify and characterize the routes by which research may reach health service managers to influence their critical decisions. Method.This research used two series of qualitative interviews, documentary analysis (a calendar study) and a card-sorting exercise to explore the workplace information practices of thirty-six health service managers. Analysis. Both interview studies used the cross-case analysis. The second interview study also used within-case analysis in the form of information transaction mapping. Information transactions, calendar study and card-sorting exercise data were reported quantitatively. Results. This exploratory study found that these health service managers overcame short time lines, unclear processes and simultaneous conflicting priorities by bringing together groups accustomed to sharing information orally to inform their critical decisions. Each decision was informed by different categories and types of information...
eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fullte... more eprints@whiterose.ac.ukhttps://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher’s website.
Falls occur frequently among older people and represent the most common cause of injury related m... more Falls occur frequently among older people and represent the most common cause of injury related morbidity and mortality in later life. Preventing falls is an important way to reduce injuries, hospitalizations and injury-related morbidity and mortality among older people. The research literature has identified hundreds of risk factors for falls among elderly people. Prioritizing risk factors for falls is useful for designing effective and efficacious prevention programs. The aim of this study was to use the Analytic Hierarchy Process to develop a hierarchy of risk factors for falls based on the knowledge and experience of experts working in this field. We designed a web portal to submit electronic questionnaires in order to reach the highest number of respondents quickly and to reduce errors in responding. We contacted the person responsible for the Falls sections of four scientific societies. Finally, we propose a correction method to modify respondents’ relative importance on the b...
Previous research has identified various risk factors for mortality in older people. The aim of t... more Previous research has identified various risk factors for mortality in older people. The aim of this paper was to use Classification and Regression Tree to predict 15-year survival in community-dwelling older people. Data were obtained from a United Kingdom representative sample of 1042 community-dwelling people aged 65 and over. Outcome was time from 1985 interview to death or censorship on February 29, 2000. Classification and Regression Tree is a non-parametric technique widely used in medical domain classification. We applied CART to the set of risk-factors identified in a previous research. The selected CART model is based on age, dose of drug prescribed and handgrip measures. It predicts survival with a sensitivity rate of 76.3% and a specificity rate of 66.3%. The selection of variables are consistent with previous research. Finally, we observed the range of risk factors and their combination associated with increased and decreased mortality.
Understanding the financial burden of chronic diseases in developing regions still remains an imp... more Understanding the financial burden of chronic diseases in developing regions still remains an important economical factor which influences the successful implementation of sensor based applications for continuous monitoring of chronic conditions. Our research focused on a comparison of literature-based data with real costs of the management and treatment of chronic diseases in a developing country, and we are using Kosovo as an example here. The results reveal that the actual living costs exceed the minimum expenses that chronic diseases impose. Following the potential of a positive economic impact of sensor based platforms for monitoring chronic conditions, we further examined the users perception of digital technology. The purpose of this paper is to present the varying cost levels of treating chronic diseases, identify the users concerns and requirements towards digital technology and discuss issues and challenges that the application of sensor based platforms imply in low and mi...
Study Objective Tools proposed to triage patient acuity in COVID-19 infection have only been vali... more Study Objective Tools proposed to triage patient acuity in COVID-19 infection have only been validated in hospital populations. We estimated the accuracy of five risk-stratification tools recommended to predict severe illness and compare accuracy to existing clinical decision-making in a pre-hospital setting. Methods An observational cohort study using linked ambulance service data for patients attended by EMS crews in the Yorkshire and Humber region of England between 18th March 2020 and 29th June 2020 was conducted to assess performance of the PRIEST tool, NEWS2, the WHO algorithm, CRB-65 and PMEWS in patients with suspected COVID-19 infection. The primary outcome was death or need for organ support. Results Of 7549 patients in our cohort, 17.6% (95% CI:16.8% to 18.5%) experienced the primary outcome. The NEWS2, PMEWS, PRIEST tool and WHO algorithm identified patients at risk of adverse outcomes with a high sensitivity (>0.95) and specificity ranging from 0.3 (NEWS2) to 0.41 (P...
In order to obtain data via Twitter, researchers may use a variety of software or they may ask fo... more In order to obtain data via Twitter, researchers may use a variety of software or they may ask for a custom tool to be created by software developers. However, different software may use different Application Programming Interfaces that may provide varying levels of Twitter data. In this study we compare data on Tweets about the Ebola virus obtained via the Firehose, and Search APIs respectively over a 3-day period in January 2015. We found that searchers with the keyword ‘Ebola’ were gathering up to 79% of all tweets using Mozdeh, and 74% of all tweets via Chorus which both use the Search API. The complete set of tweets was 195,713 Tweets (100%) obtained via Texifter and subsequently stored in DiscoverText.
Abstract In this paper, we attempt to utilize the information that is inherent in electronic heal... more Abstract In this paper, we attempt to utilize the information that is inherent in electronic health records (EHR) to predict clinical risks of acute coronary syndrome (ACS) patients. Because EHR data are typically highly-dimensional and non-linear, we propose a novel relational regularization-based feature selection method to identify informative risk factors from EHR data, on which a sparse ACS risk prediction model can be built. Specifically, we formulate our objective function by imposing two types of correlational characteristics, i.e., feature-feature relations and sample-sample relations, along with an l2-norm regularization term, to extract significant risk factors from EHR data. With the dimension-reduced EHR data, we train a Softmax Regression model to predict clinical risks of ACS patients. To validate the effectiveness of the proposed method, a case study was conducted on a real ACS clinical data-set that was collected from a Chinese hospital. The experimental results demonstrate the efficacy of the proposed method for improving the performance of ACS risk prediction via relational regularized risk factor selection by a comparison with state-of-the-art methods.
Journal of medical Internet research, Jan 14, 2018
The availability of an increasing number of online health forums has altered the experience of li... more The availability of an increasing number of online health forums has altered the experience of living with a health condition, as more people are now able to connect and support one another. Empathy is an important component of peer-to-peer support, although little is known about how empathy develops and operates within online health forums. The aim of this paper is to explore how empathy develops and operates within two online health forums for differing health conditions: breast cancer and motor neuron disease (MND), also known as amyotrophic lateral sclerosis. This qualitative study analyzed data from two sources: interviews with forum users and downloaded forum posts. Data were collected from two online health forums provided by UK charities: Breast Cancer Care and the Motor Neurone Disease Association. We analyzed 84 threads from the breast cancer forum and 52 from the MND forum. Threads were purposively sampled to reflect varied experiences (eg, illness stages, topics of conve...
Cancer of unknown primary is the fourth most common cause of cancer death in the United Kingdom. ... more Cancer of unknown primary is the fourth most common cause of cancer death in the United Kingdom. National guidance in 2010 recommended the establishment of a dedicated unknown primary team to facilitate targeted investigation and symptom control. A service development project was undertaken to identify those affected by malignancy of unknown origin and institute a pathway for coordinating their care led by a palliative physician. In order to describe the patient population and illness trajectory and to assess the effect of the new pathway on the clinical outcomes we used a retrospective and prospective comparative case notes survey to identify the pre- and post-pathway population. This took place in secondary care. Inclusion criteria were patients with metastatic disease with no known primary; exclusion criteria were where the site of metastasis was so suggestive of a primary that it would be managed as per that disease process. 88 patients were included. Mean age was 72.5 years. Th...
ObjectiveTo assess accuracy of telephone triage in identifying patients who need emergency care a... more ObjectiveTo assess accuracy of telephone triage in identifying patients who need emergency care amongst those with suspected COVID-19 infection and identify factors which affect triage accuracy.DesignObservational cohort studySettingCommunity telephone triage in the Yorkshire and Humber, Bassetlaw, North Lincolnshire and North East Lincolnshire region.Participants40, 261 adults who contacted NHS 111 telephone triage services provided by Yorkshire Ambulance Service NHS Trust between the 18th March 2020 and 29th June 2020 with symptoms indicating possible COVID-19 infection were linked to Office for National Statistics death registration data, hospital and general practice electronic health care data collected by NHS Digital.OutcomeAccuracy of triage disposition (self-care/non-urgent clinical assessment versus ambulance dispatch/urgent clinical assessment) was assessed in terms of death or need for organ support at 30, 7 and 3 days from first contact with the telephone triage service....
Introduction. The aim of this paper is to identify and characterize the routes by which research ... more Introduction. The aim of this paper is to identify and characterize the routes by which research may reach health service managers to influence their critical decisions. Method.This research used two series of qualitative interviews, documentary analysis (a calendar study) and a card-sorting exercise to explore the workplace information practices of thirty-six health service managers. Analysis. Both interview studies used the cross-case analysis. The second interview study also used within-case analysis in the form of information transaction mapping. Information transactions, calendar study and card-sorting exercise data were reported quantitatively. Results. This exploratory study found that these health service managers overcame short time lines, unclear processes and simultaneous conflicting priorities by bringing together groups accustomed to sharing information orally to inform their critical decisions. Each decision was informed by different categories and types of information...
eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fullte... more eprints@whiterose.ac.ukhttps://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher’s website.
Falls occur frequently among older people and represent the most common cause of injury related m... more Falls occur frequently among older people and represent the most common cause of injury related morbidity and mortality in later life. Preventing falls is an important way to reduce injuries, hospitalizations and injury-related morbidity and mortality among older people. The research literature has identified hundreds of risk factors for falls among elderly people. Prioritizing risk factors for falls is useful for designing effective and efficacious prevention programs. The aim of this study was to use the Analytic Hierarchy Process to develop a hierarchy of risk factors for falls based on the knowledge and experience of experts working in this field. We designed a web portal to submit electronic questionnaires in order to reach the highest number of respondents quickly and to reduce errors in responding. We contacted the person responsible for the Falls sections of four scientific societies. Finally, we propose a correction method to modify respondents’ relative importance on the b...
Previous research has identified various risk factors for mortality in older people. The aim of t... more Previous research has identified various risk factors for mortality in older people. The aim of this paper was to use Classification and Regression Tree to predict 15-year survival in community-dwelling older people. Data were obtained from a United Kingdom representative sample of 1042 community-dwelling people aged 65 and over. Outcome was time from 1985 interview to death or censorship on February 29, 2000. Classification and Regression Tree is a non-parametric technique widely used in medical domain classification. We applied CART to the set of risk-factors identified in a previous research. The selected CART model is based on age, dose of drug prescribed and handgrip measures. It predicts survival with a sensitivity rate of 76.3% and a specificity rate of 66.3%. The selection of variables are consistent with previous research. Finally, we observed the range of risk factors and their combination associated with increased and decreased mortality.
Understanding the financial burden of chronic diseases in developing regions still remains an imp... more Understanding the financial burden of chronic diseases in developing regions still remains an important economical factor which influences the successful implementation of sensor based applications for continuous monitoring of chronic conditions. Our research focused on a comparison of literature-based data with real costs of the management and treatment of chronic diseases in a developing country, and we are using Kosovo as an example here. The results reveal that the actual living costs exceed the minimum expenses that chronic diseases impose. Following the potential of a positive economic impact of sensor based platforms for monitoring chronic conditions, we further examined the users perception of digital technology. The purpose of this paper is to present the varying cost levels of treating chronic diseases, identify the users concerns and requirements towards digital technology and discuss issues and challenges that the application of sensor based platforms imply in low and mi...
Study Objective Tools proposed to triage patient acuity in COVID-19 infection have only been vali... more Study Objective Tools proposed to triage patient acuity in COVID-19 infection have only been validated in hospital populations. We estimated the accuracy of five risk-stratification tools recommended to predict severe illness and compare accuracy to existing clinical decision-making in a pre-hospital setting. Methods An observational cohort study using linked ambulance service data for patients attended by EMS crews in the Yorkshire and Humber region of England between 18th March 2020 and 29th June 2020 was conducted to assess performance of the PRIEST tool, NEWS2, the WHO algorithm, CRB-65 and PMEWS in patients with suspected COVID-19 infection. The primary outcome was death or need for organ support. Results Of 7549 patients in our cohort, 17.6% (95% CI:16.8% to 18.5%) experienced the primary outcome. The NEWS2, PMEWS, PRIEST tool and WHO algorithm identified patients at risk of adverse outcomes with a high sensitivity (>0.95) and specificity ranging from 0.3 (NEWS2) to 0.41 (P...
In order to obtain data via Twitter, researchers may use a variety of software or they may ask fo... more In order to obtain data via Twitter, researchers may use a variety of software or they may ask for a custom tool to be created by software developers. However, different software may use different Application Programming Interfaces that may provide varying levels of Twitter data. In this study we compare data on Tweets about the Ebola virus obtained via the Firehose, and Search APIs respectively over a 3-day period in January 2015. We found that searchers with the keyword ‘Ebola’ were gathering up to 79% of all tweets using Mozdeh, and 74% of all tweets via Chorus which both use the Search API. The complete set of tweets was 195,713 Tweets (100%) obtained via Texifter and subsequently stored in DiscoverText.
Abstract In this paper, we attempt to utilize the information that is inherent in electronic heal... more Abstract In this paper, we attempt to utilize the information that is inherent in electronic health records (EHR) to predict clinical risks of acute coronary syndrome (ACS) patients. Because EHR data are typically highly-dimensional and non-linear, we propose a novel relational regularization-based feature selection method to identify informative risk factors from EHR data, on which a sparse ACS risk prediction model can be built. Specifically, we formulate our objective function by imposing two types of correlational characteristics, i.e., feature-feature relations and sample-sample relations, along with an l2-norm regularization term, to extract significant risk factors from EHR data. With the dimension-reduced EHR data, we train a Softmax Regression model to predict clinical risks of ACS patients. To validate the effectiveness of the proposed method, a case study was conducted on a real ACS clinical data-set that was collected from a Chinese hospital. The experimental results demonstrate the efficacy of the proposed method for improving the performance of ACS risk prediction via relational regularized risk factor selection by a comparison with state-of-the-art methods.
Journal of medical Internet research, Jan 14, 2018
The availability of an increasing number of online health forums has altered the experience of li... more The availability of an increasing number of online health forums has altered the experience of living with a health condition, as more people are now able to connect and support one another. Empathy is an important component of peer-to-peer support, although little is known about how empathy develops and operates within online health forums. The aim of this paper is to explore how empathy develops and operates within two online health forums for differing health conditions: breast cancer and motor neuron disease (MND), also known as amyotrophic lateral sclerosis. This qualitative study analyzed data from two sources: interviews with forum users and downloaded forum posts. Data were collected from two online health forums provided by UK charities: Breast Cancer Care and the Motor Neurone Disease Association. We analyzed 84 threads from the breast cancer forum and 52 from the MND forum. Threads were purposively sampled to reflect varied experiences (eg, illness stages, topics of conve...
Cancer of unknown primary is the fourth most common cause of cancer death in the United Kingdom. ... more Cancer of unknown primary is the fourth most common cause of cancer death in the United Kingdom. National guidance in 2010 recommended the establishment of a dedicated unknown primary team to facilitate targeted investigation and symptom control. A service development project was undertaken to identify those affected by malignancy of unknown origin and institute a pathway for coordinating their care led by a palliative physician. In order to describe the patient population and illness trajectory and to assess the effect of the new pathway on the clinical outcomes we used a retrospective and prospective comparative case notes survey to identify the pre- and post-pathway population. This took place in secondary care. Inclusion criteria were patients with metastatic disease with no known primary; exclusion criteria were where the site of metastasis was so suggestive of a primary that it would be managed as per that disease process. 88 patients were included. Mean age was 72.5 years. Th...
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Papers by Peter Bath