2024
Detection of Gastrointestinal Bleeding with Large Language Models to Aid Quality Improvement and Appropriate Reimbursement
Zheng N, Keloth V, You K, Kats D, Li D, Deshpande O, Sachar H, Xu H, Laine L, Shung D. Detection of Gastrointestinal Bleeding with Large Language Models to Aid Quality Improvement and Appropriate Reimbursement. Gastroenterology 2024 PMID: 39304088, DOI: 10.1053/j.gastro.2024.09.014.Peer-Reviewed Original ResearchElectronic health recordsOvert gastrointestinal bleedingGastrointestinal bleedingRecurrent bleedingMachine learning modelsHealth recordsClinically relevant applicationsNursing notesLanguage modelAcute gastrointestinal bleedingQuality improvementLearning modelsDetection of gastrointestinal bleedingReimbursementIdentification of clinical conditionsSeparate hospitalsQuality measuresHospitalBleedingClinical conditionsPatient managementEarly identificationPatientsReimbursement codesCoding algorithm
2023
Achieving Value by Risk Stratification With Machine Learning Model or Clinical Risk Score in Acute Upper Gastrointestinal Bleeding: A Cost Minimization Analysis
Shung D, Lin J, Laine L. Achieving Value by Risk Stratification With Machine Learning Model or Clinical Risk Score in Acute Upper Gastrointestinal Bleeding: A Cost Minimization Analysis. The American Journal Of Gastroenterology 2023, 119: 371-373. PMID: 37753930, PMCID: PMC10872988, DOI: 10.14309/ajg.0000000000002520.Peer-Reviewed Original ResearchUpper gastrointestinal bleedingCost-minimization analysisGastrointestinal bleedingUsual careTriage strategiesAcute upper gastrointestinal bleedingClinical risk scoreLow-risk patientsHealthcare payer perspectiveMinimization analysisRisk assessment toolRisk stratificationEmergency departmentPayer perspectiveRisk scoreBleedingAssessment toolCareRisk assessment modelMachine-learning strategiesPatientsCumulative savingsManagement of Bleeding Due to Small-Intestinal Angiodysplasias
Laine L. Management of Bleeding Due to Small-Intestinal Angiodysplasias. New England Journal Of Medicine 2023, 389: 1718-1720. PMID: 37913510, DOI: 10.1056/nejme2310338.Commentaries, Editorials and Letters
2022
Rebleeding in peptic ulcer bleeding – a nationwide cohort study of 19,537 patients
Laursen S, Stanley A, Laine L, de Muckadell O. Rebleeding in peptic ulcer bleeding – a nationwide cohort study of 19,537 patients. Scandinavian Journal Of Gastroenterology 2022, 57: 1423-1429. PMID: 35853234, DOI: 10.1080/00365521.2022.2098050.Peer-Reviewed Original ResearchConceptsPeptic ulcer bleedingNationwide cohort studyUlcer bleedingHemodynamic instabilityCohort studyDuodenal ulcerHigh-risk endoscopic stigmataNon-ulcer lesionsHigh-risk stigmataLogistic regression analysisEndoscopic stigmataPersistent bleedingEndoscopic therapyFrequent complicationConsecutive patientsSuch patientsPrognostic consequencesHigh riskPatientsInterventional radiologyBleedingTwo-fold increaseMortalityUlcersStrongest predictorAssociation of Antisecretory Drugs with Upper Gastrointestinal Bleeding in Patients Using Oral Anticoagulants: A Systematic Review and Meta-Analysis
Kurlander JE, Barnes GD, Fisher A, Gonzalez JJ, Helminski D, Saini SD, Sengupta N, Yang YX, Scheiman J, Laine L. Association of Antisecretory Drugs with Upper Gastrointestinal Bleeding in Patients Using Oral Anticoagulants: A Systematic Review and Meta-Analysis. The American Journal Of Medicine 2022, 135: 1231-1243.e8. PMID: 35679879, PMCID: PMC10031639, DOI: 10.1016/j.amjmed.2022.05.031.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingProton pump inhibitorsGastrointestinal bleedingH2-receptor antagonistsObservational studyOral anticoagulantsAntisecretory drugsRelative riskLower riskNonsteroidal anti-inflammatory drug useSystematic reviewAnti-inflammatory drug useOvert upper gastrointestinal bleedingLow statistical heterogeneitySingle observational studyGreater treatment effectRandom-effects modelWeb of ScienceConcomitant aspirinRandomized trialsCochrane LibraryPump inhibitorsBias assessmentStatistical heterogeneityBleedingInternational multicenter study comparing demographics, therapy and outcomes in bleeding from Mallory Weiss tears and peptic ulcers
Tham JE, Lynch L, Laursen SB, Laine L, Dalton HR, Ngu J, Redondo-Cerezo E, Schultz M, Murray I, Michell N, Morris AJ, Nielsen MM, Stanley AJ. International multicenter study comparing demographics, therapy and outcomes in bleeding from Mallory Weiss tears and peptic ulcers. Endoscopy International Open 2022, 10: e653-e658. PMID: 35571482, PMCID: PMC9106442, DOI: 10.1055/a-1784-0655.Peer-Reviewed Original ResearchMallory-Weiss tearUpper gastrointestinal bleedingPeptic ulcer bleedingEndoscopic therapyEndoscopic stigmataEpinephrine injectionAcute upper gastrointestinal bleedingInternational multicenter studyPUB patientsGastrointestinal bleedingUlcer bleedingUncommon causeMulticenter studyPeptic ulcerPoor outcomeScope clipInternational cohortClean baseLower riskBaseline parametersPatientsTherapyBleedingCommon modalityMortalityManagement of Patients on Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Peri-Endoscopic Period: A Clinical Practice Guideline Dissemination Tool
Barkun AN, Douketis J, Noseworthy PA, Laine L, Telford JJ, Abraham NS. Management of Patients on Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Peri-Endoscopic Period: A Clinical Practice Guideline Dissemination Tool. The American Journal Of Gastroenterology 2022, 117: 513-519. PMID: 35354773, DOI: 10.14309/ajg.0000000000001688.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2021
Antiplatelet Monotherapy Is Associated with an Increased Risk of Bleeding After Endoscopic Sphincterotomy
Zakko A, Zakko L, Grimshaw AA, Laine L. Antiplatelet Monotherapy Is Associated with an Increased Risk of Bleeding After Endoscopic Sphincterotomy. Digestive Diseases And Sciences 2021, 67: 4161-4169. PMID: 34796411, DOI: 10.1007/s10620-021-07302-w.Peer-Reviewed Original ResearchConceptsEndoscopic retrograde cholangiopancreatographyPost-sphincterotomy bleedingAntiplatelet monotherapyInclusion criteriaRisk of bleedingROBINS-I toolNewcastle-Ottawa ScaleHigh-quality studiesRandom-effects modelBackgroundClinical guidelinesAntithrombotic therapyAdult patientsCohort studyEndoscopic sphincterotomyPrimary outcomeAntiplatelet agentsOvid EmbaseRetrograde cholangiopancreatographyCochrane LibraryOvid MEDLINEMonotherapyMethodological qualityBleedingUnique citationsPatientsTowards personalised management for non-variceal upper gastrointestinal bleeding
Sung JJY, Laine L, Kuipers EJ, Barkun AN. Towards personalised management for non-variceal upper gastrointestinal bleeding. Gut 2021, 70: 818-824. PMID: 33649044, DOI: 10.1136/gutjnl-2020-323846.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsIndividual patientsNon-variceal upper gastrointestinal bleedingPre-endoscopic assessmentUpper gastrointestinal bleedingImportant clinical issuePostendoscopic managementGastrointestinal bleedingPatient characteristicsEndoscopic evaluationPoint of careOptimal treatmentInternational guidelinesClinical issuesInternational professional societiesClinical settingSpecific management strategiesStages of managementPatientsTreatmentProfessional societiesManagement strategiesGuidelinesBleedingHaemostasisLesions
2020
Machine Learning Prognostic Models for Gastrointestinal Bleeding Using Electronic Health Record Data.
Shung D, Laine L. Machine Learning Prognostic Models for Gastrointestinal Bleeding Using Electronic Health Record Data. The American Journal Of Gastroenterology 2020, 115: 1199-1200. PMID: 32530828, PMCID: PMC7415736, DOI: 10.14309/ajg.0000000000000720.Commentaries, Editorials and LettersConceptsRisk assessment toolGastrointestinal bleedingIntensive care unit patientsClinical risk assessment toolCare unit patientsElectronic health record dataHealth record dataLevel of careAssessment toolElectronic health recordsAPACHE IVaHospital mortalityHospital courseUnit patientsPrognostic toolClinical practicePrognostic modelHealth recordsRecord dataBleedingExternal validationPatientsLack of generalizabilityMortalityCareTiming of Endoscopy in Patients Hospitalized with Upper Gastrointestinal Bleeding
Laine L. Timing of Endoscopy in Patients Hospitalized with Upper Gastrointestinal Bleeding. New England Journal Of Medicine 2020, 382: 1361-1363. PMID: 32242363, DOI: 10.1056/nejme2002121.Commentaries, Editorials and Letters
2019
Early Colonoscopy Does Not Improve Outcomes of Patients With Lower Gastrointestinal Bleeding: Systematic Review of Randomized Trials
Tsay C, Shung D, Stemmer Frumento K, Laine L. Early Colonoscopy Does Not Improve Outcomes of Patients With Lower Gastrointestinal Bleeding: Systematic Review of Randomized Trials. Clinical Gastroenterology And Hepatology 2019, 18: 1696-1703.e2. PMID: 31843595, PMCID: PMC7292779, DOI: 10.1016/j.cgh.2019.11.061.Peer-Reviewed Original ResearchConceptsAcute lower gastrointestinal bleedingLower gastrointestinal bleedingRandomized trialsEarly colonoscopyElective colonoscopyGastrointestinal bleedingSecondary outcomesHemostatic interventionEndoscopic interventionDiagnostic yieldSevere acute lower gastrointestinal bleedingSystematic reviewDual independent reviewTiming of colonoscopyOutcomes of patientsHours of presentationRandom-effects modelRecurrent bleedingPrimary outcomeIndex examinationColonoscopy evaluationBias assessmentObservational studyBleedingColonoscopyThe Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding
Saffouri E, Blackwell C, Laursen SB, Laine L, Dalton HR, Ngu J, Shultz M, Norton R, Stanley AJ. The Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2019, 51: 253-260. PMID: 31642558, DOI: 10.1111/apt.15541.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overArea Under CurveBlood TransfusionCohort StudiesEndoscopy, GastrointestinalFemaleGastrointestinal HemorrhageHospitalizationHumansMaleMiddle AgedMortalityPredictive Value of TestsPrognosisProspective StudiesReproducibility of ResultsRisk AssessmentSeverity of Illness IndexShockSurvival AnalysisUpper Gastrointestinal TractYoung AdultConceptsUpper gastrointestinal bleedingGlasgow-Blatchford scoreShock indexGastrointestinal bleedingABC scoreMajor transfusionAcute upper gastrointestinal bleedingUK National Confidential EnquiryAdmission Rockall scoreSevere gastrointestinal bleedingMajor clinical endpointsPredictors of outcomeNational Confidential EnquiryRockall scoreBlatchford scoreEndoscopic therapyConsecutive patientsHospital admissionConfidential EnquiryProspective studyClinical endpointsPatient outcomesRisk scoreDeath reportsBleedingMAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding
Redondo‐Cerezo E, Vadillo‐Calles F, Stanley AJ, Laursen S, Laine L, Dalton HR, Ngu JH, Schultz M, Jiménez‐Rosales R. MAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding. Journal Of Gastroenterology And Hepatology 2019, 35: 82-89. PMID: 31359521, DOI: 10.1111/jgh.14811.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingGastrointestinal bleedingEndoscopic interventionGlasgow-Blatchford scoreSystolic blood pressureNew scoring systemBlatchford scoreProspective databaseBlood pressureRisk stratificationValidation cohortDevelopment cohortOriginal cohortEmergency roomMental statusRisk scoreClinical practiceFair discriminationScoring systemPatientsMortalityCohortNew scoreInterventionBleeding
2017
Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study
Stanley AJ, Laine L, Dalton HR, Ngu JH, Schultz M, Abazi R, Zakko L, Thornton S, Wilkinson K, Khor CJ, Murray IA, Laursen SB. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. The BMJ 2017, 356: i6432. PMID: 28053181, PMCID: PMC5217768, DOI: 10.1136/bmj.i6432.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingRockall scoreGastrointestinal bleedingInternational multicentre prospective studyAdmission Rockall scoreFull Rockall scoreGlasgow-Blatchford scoreHigh-risk patientsMulticentre prospective studyAssessment of patientsPNED scoreHospital stayBlatchford scoreDay mortalityConsecutive patientsRisk patientsComposite endpointEndoscopic treatmentProspective studyClinical endpointsClinical utilityLower riskPatientsLarge hospitalsBleeding
2016
Randomized trial of 1‐week versus 2‐week intervals for endoscopic ligation in the treatment of patients with esophageal variceal bleeding
Sheibani S, Khemichian S, Kim JJ, Hou L, Yan AW, Buxbaum J, Dara L, Laine L. Randomized trial of 1‐week versus 2‐week intervals for endoscopic ligation in the treatment of patients with esophageal variceal bleeding. Hepatology 2016, 64: 549-555. PMID: 27082942, PMCID: PMC4956532, DOI: 10.1002/hep.28597.Peer-Reviewed Original ResearchConceptsEsophageal variceal bleedingVariceal bleedingVariceal eradicationAcute esophageal variceal bleedingBeta-blocker therapyProportion of patientsTreatment of patientsNumber of endoscopiesMean numberLigation sessionsChest painPrimary endpointAdverse eventsClinical outcomesEndoscopic ligationLast endoscopyPhysician preferencePatientsBleedingSuccessful ligationEndoscopyConfidence intervalsEradicationLigationWeeks
2015
Early Use of TIPS and Outcomes in Patients With Cirrhosis and Acute Esophageal Variceal Bleeding: Analysis of the U.S. Nationwide Inpatient Sample (NIS) Database, 2000-2010: ACG Fellows-In-Training Award
Njei B, Laine L. Early Use of TIPS and Outcomes in Patients With Cirrhosis and Acute Esophageal Variceal Bleeding: Analysis of the U.S. Nationwide Inpatient Sample (NIS) Database, 2000-2010: ACG Fellows-In-Training Award. The American Journal Of Gastroenterology 2015, 110: s870. DOI: 10.14309/00000434-201510001-02070.Peer-Reviewed Original Research
2012
Trends for Incidence of Hospitalization and Death Due to GI Complications in the United States From 2001 to 2009
Laine L, Yang H, Chang SC, Datto C. Trends for Incidence of Hospitalization and Death Due to GI Complications in the United States From 2001 to 2009. The American Journal Of Gastroenterology 2012, 107: 1190. PMID: 22688850, DOI: 10.1038/ajg.2012.168.Peer-Reviewed Original ResearchConceptsCase fatalityGI complicationsLGI bleedingUGI bleedingUGI complicationsGastrointestinal complicationsLower gastrointestinal complicationsColonic diverticular bleedingIncidence of hospitalizationNational inpatient databasePeptic ulcer bleedingPrimary discharge diagnosisSex-adjusted incidenceUpper gastrointestinal complicationsCase fatality rateDiverticular bleedingUGI perforationsGI bleedingUlcer bleedingDischarge diagnosisInpatient DatabaseBleedingComplicationsFatality rateHospitalization
2010
Treatment of Acute Bleeding
Laine L, Abid S, Albillos A, Kamath P, Vinel J, García‐Pagán J. Treatment of Acute Bleeding. 2010, 101-118. DOI: 10.1002/9781444393989.ch10.ChaptersDoes Capsule Endoscopy Improve Outcomes in Obscure Gastrointestinal Bleeding? Randomized Trial Versus Dedicated Small Bowel Radiography
Laine L, Sahota A, Shah A. Does Capsule Endoscopy Improve Outcomes in Obscure Gastrointestinal Bleeding? Randomized Trial Versus Dedicated Small Bowel Radiography. Gastroenterology 2010, 138: 1673-1680.e1. PMID: 20138043, DOI: 10.1053/j.gastro.2010.01.047.Peer-Reviewed Original ResearchConceptsObscure GI bleedingObscure gastrointestinal bleedingDiagnostic yieldGI bleedingGastrointestinal bleedingTherapeutic interventionsCapsule endoscopyNegative upper endoscopySubsequent blood transfusionSmall bowel radiographyOccult bleedingPrimary endpointSubsequent hospitalizationMost patientsUpper endoscopyBlood transfusionHemoglobin levelsRandomized trialsVs 5Improved outcomesBleedingContrast radiographyPatientsEndoscopyAbstractText