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 LettersS11 Cholecystectomy Reduces the Odds of Inpatient Mortality in Patients With Acute Biliary Pancreatitis
Restrepo D, Doshi R, Nawaz A, Chaar A, Kothari T, Laine L, Muniraj T. S11 Cholecystectomy Reduces the Odds of Inpatient Mortality in Patients With Acute Biliary Pancreatitis. The American Journal Of Gastroenterology 2023, 118: s9-s10. DOI: 10.14309/01.ajg.0000949684.33264.0a.Peer-Reviewed Original ResearchSu1920 IMPACT OF OBESITY AND MORBID OBESITY ON OUTCOMES OF PATIENTS UNDERGOING ENDOSCOPIC PANCREATIC NECRESECTOMY
Nawaz A, Chaar A, Rizwan R, Fetene J, Restrepo D, Alchirazi K, Abdulkarim D, Khalid F, Mathialagan K, Cheung M, Laine L, Muniraj T. Su1920 IMPACT OF OBESITY AND MORBID OBESITY ON OUTCOMES OF PATIENTS UNDERGOING ENDOSCOPIC PANCREATIC NECRESECTOMY. Gastroenterology 2023, 164: s-714. DOI: 10.1016/s0016-5085(23)02660-4.Peer-Reviewed Original ResearchSa1420 FRAILTY IS ASSOCIATED WITH POOR OUTCOMES IN PATIENTS ADMITTED FOR ACUTE NECROTIZING PANCREATITIS
Nawaz A, Chaar A, Rizwan R, Restrepo D, Fetene J, Alchirazi K, Abdulkarim D, Khalid F, Doshi R, Mathialagan K, Hung K, Laine L, Muniraj T. Sa1420 FRAILTY IS ASSOCIATED WITH POOR OUTCOMES IN PATIENTS ADMITTED FOR ACUTE NECROTIZING PANCREATITIS. Gastroenterology 2023, 164: s-390. DOI: 10.1016/s0016-5085(23)01905-4.Peer-Reviewed Original ResearchPlasma renalase levels are associated with the development of acute pancreatitis
Wang M, Weiss F, Guo X, Kolodecik T, Bewersdorf J, Laine L, Lerch M, Desir G, Gorelick F. Plasma renalase levels are associated with the development of acute pancreatitis. Pancreatology 2023, 23: 158-162. PMID: 36697349, DOI: 10.1016/j.pan.2023.01.001.Peer-Reviewed Original ResearchConceptsAcute pancreatitisSevere diseasePlasma renalase levelsAcute pancreatitis patientsSevere acute pancreatitisAcute pancreatitis modelPlasma renalaseRenalase levelsSignificant morbidityPancreatitis patientsPlasma levelsHealthy controlsPancreatitis modelPancreatitisPatientsPlasma samplesRenalaseDiseaseNonparametric statistical analysisSecretory proteinsMorbidityStatistical analysisMortalityLevels
2022
Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding
Li D, Ong S, Hughes M, Hung K, Agarwal R, Alexis J, Damianos J, Sharma S, Pires J, Nanna M, Laine L. Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding. Alimentary Pharmacology & Therapeutics 2022, 57: 94-102. PMID: 36394111, DOI: 10.1111/apt.17278.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsGastrointestinal bleedingPrimary preventionCardiovascular eventsRisk of MACEYale-New Haven HospitalPrimary cardiovascular preventionAdverse cardiovascular eventsKaplan-Meier curvesLong-term outcomesRisk-benefit ratioLog-rank testAspirin 81Hospitalised patientsPrimary endpointSecondary endpointsCardiovascular preventionSubsequent hospitalisationMedian ageDeprescriptionHigh riskAspirinHospitalisationPatientsPreventionDisparities in Access to Endoscopy for Patients With Upper Gastrointestinal Bleeding Presenting to Emergency Departments
Rodriguez NJ, Zheng N, Mezzacappa C, Canavan M, Laine L, Shung D. Disparities in Access to Endoscopy for Patients With Upper Gastrointestinal Bleeding Presenting to Emergency Departments. Gastroenterology 2022, 164: 1044-1046.e4. PMID: 36228735, PMCID: PMC10083188, DOI: 10.1053/j.gastro.2022.10.001.Peer-Reviewed Original ResearchVonoprazan Versus Lansoprazole for Healing and Maintenance of Healing of Erosive Esophagitis: A Randomized Trial
Laine L, DeVault K, Katz P, Mitev S, Lowe J, Hunt B, Spechler S. Vonoprazan Versus Lansoprazole for Healing and Maintenance of Healing of Erosive Esophagitis: A Randomized Trial. Gastroenterology 2022, 164: 61-71. PMID: 36228734, DOI: 10.1053/j.gastro.2022.09.041.Peer-Reviewed Original ResearchConceptsMaintenance of healingProton pump inhibitorsErosive esophagitisSecondary analysisD esophagitisPrimary analysisEnd pointPotassium-competitive acid blocker vonoprazanHeartburn-free daysSevere erosive esophagitisMainstay of treatmentPrimary end pointSecondary end pointsPotent acid inhibitionPPI lansoprazolePump inhibitorsEsophagitisNoninferiority comparisonVonoprazanWeek 2Healing phaseAbstractTextPatientsLansoprazoleSuperiority analysisRebleeding 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 predictorInternational 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
ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an international multicentre study
Laursen SB, Oakland K, Laine L, Bieber V, Marmo R, Redondo-Cerezo E, Dalton HR, Ngu J, Schultz M, Soncini M, Gralnek I, Jairath V, Murray IA, Stanley AJ. ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an international multicentre study. Gut 2020, 70: 707-716. PMID: 32723845, DOI: 10.1136/gutjnl-2019-320002.Peer-Reviewed Original ResearchConceptsLower gastrointestinal bleedingABC scoreLower riskHigher ABC scoresGastrointestinal bleedingRisk scoreMortality rateHospital mortality rateInternational cohort studyManagement of patientsNew risk scoreInternational multicentre studyLower ABC scoreLGIB patientsUGIB patientsComorbidity scoreCohort studyMulticentre studyBlood testsValidation cohortDevelopment cohortLGIBUGIBHigh riskPatientsMachine 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 LettersPhysicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey.
Kurlander JE, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Zikmund-Fisher BJ, Yang YX, Laine L, Weissman A, Saini SD. Physicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey. The American Journal Of Gastroenterology 2020, 115: 689-696. PMID: 32091419, PMCID: PMC7196016, DOI: 10.14309/ajg.0000000000000558.Peer-Reviewed Original ResearchConceptsProton pump inhibitorsPPI adverse effectsAdverse effectsHigh riskLong-term PPI useGastroesophageal reflux diseaseMultiple adverse effectsPPI useReflux diseasePPI discontinuationInhibitor riskMost internistsPump inhibitorsPhysicians' perceptionsInternists' perceptionsSignificant associationGeneral medicineDiscontinuationLogistic regressionClinical usePatientsFuture interventionsIndividual riskPreventionUGIB
2019
Validation of a Machine Learning Model That Outperforms Clinical Risk Scoring Systems for Upper Gastrointestinal Bleeding
Shung DL, Au B, Taylor RA, Tay JK, Laursen SB, Stanley AJ, Dalton HR, Ngu J, Schultz M, Laine L. Validation of a Machine Learning Model That Outperforms Clinical Risk Scoring Systems for Upper Gastrointestinal Bleeding. Gastroenterology 2019, 158: 160-167. PMID: 31562847, PMCID: PMC7004228, DOI: 10.1053/j.gastro.2019.09.009.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingHospital-based interventionsComposite endpointScoring systemRockall scoreGastrointestinal bleedingClinical riskConsecutive unselected patientsLow-risk patientsClinical scoring systemRisk-scoring systemExternal validation cohortCharacteristic curve analysisInternal validation setOutpatient managementUnselected patientsValidation cohortEmergency departmentMedical CenterGreater AUCPatientsAbstractTextCurve analysisEndpointAUC