2024
Validation of an Electronic Health Record-Based Machine Learning Model Compared to Clinical Risk Scores for Gastrointestinal Bleeding
Shung D, Chan C, You K, Nakamura S, Saarinen T, Zheng N, Simonov M, Li D, Tsay C, Kawamura Y, Shen M, Hsiao A, Sekhon J, Laine L. Validation of an Electronic Health Record-Based Machine Learning Model Compared to Clinical Risk Scores for Gastrointestinal Bleeding. Gastroenterology 2024 PMID: 38971198, DOI: 10.1053/j.gastro.2024.06.030.Peer-Reviewed Original ResearchElectronic health recordsGlasgow-Blatchford scoreEmergency departmentVery-low-risk patientsRisk scoreOakland scoreMachine learning modelsStructured data fieldsClinical risk scoreGastrointestinal bleedingAll-cause mortalityHealth recordsLearning modelsManual data entrySecondary analysisRisk stratification scoresAssess proportionRed blood-cell transfusionPrimary outcomeProportion of patientsData entryOvert gastrointestinal bleedingPrimary analysisReceiver-operating-characteristic curveVery-low-riskAdoption of a gastroenterology hospitalist model and the impact on inpatient endoscopic practice volume: a controlled interrupted time-series analysis
Shung D, Li D, You K, Hung K, Laine L, Hughes M. Adoption of a gastroenterology hospitalist model and the impact on inpatient endoscopic practice volume: a controlled interrupted time-series analysis. IGIE 2024, 3: 329-332.e2. DOI: 10.1016/j.igie.2024.04.008.Peer-Reviewed Original ResearchControlled interrupted time series analysisHospitalist modelInterrupted time series analysisHigh-acuity hospitalAcademic health systemEndoscopy capacityInpatient coverageOutpatient providersProvider familiarityOutpatient careHealth systemWeekly volumeEndoscopy volumeHospital systemPractice volumeTime series analysisProcedure volumeGI patientsHospitalAcademic centersProvidersGastroenterologySeries analysisPotential benefitsEndoscopic proceduresComparison of LA Grades of Erosive Esophagitis Scored by Local Investigators vs Central Adjudicators in a Clinical Trial
Spechler S, Laine L, DeVault K, Nabulsi A, Hunt B, Katz P. Comparison of LA Grades of Erosive Esophagitis Scored by Local Investigators vs Central Adjudicators in a Clinical Trial. Clinical Gastroenterology And Hepatology 2024 PMID: 38777170, DOI: 10.1016/j.cgh.2024.05.007.Peer-Reviewed Original ResearchVONOPRAZAN IS EFFICACIOUS FOR TREATMENT OF HEARTBURN IN NON-EROSIVE REFLUX DISEASE: A RANDOMIZED TRIAL
Laine L, Spechler S, Yadlapati R, Schnoll-Sussman F, Smith N, Leifke E, Harris T, Hunt B, Fass R, Katz P. VONOPRAZAN IS EFFICACIOUS FOR TREATMENT OF HEARTBURN IN NON-EROSIVE REFLUX DISEASE: A RANDOMIZED TRIAL. Clinical Gastroenterology And Hepatology 2024 PMID: 38750866, DOI: 10.1016/j.cgh.2024.05.004.Peer-Reviewed Original ResearchNon-erosive reflux diseaseHeartburn-free daysErosive esophagitisReflux diseaseRandomized trialsActive-treatment extensionRandomized to placeboPotassium-competitive acid blockerPlacebo-controlled periodDays of therapyPercentage of subjectsPrimary endpointPercentage of daysHeartburn symptomsPlaceboVonoprazanAcid blockerNighttime heartburnDay 1Randomized subjectsDocumented efficacyStudy armsDay 2Adult subjectsExtension periodHuman-Algorithmic Interaction Using a Large Language Model-Augmented Artificial Intelligence Clinical Decision Support System
Rajashekar N, Shin Y, Pu Y, Chung S, You K, Giuffre M, Chan C, Saarinen T, Hsiao A, Sekhon J, Wong A, Evans L, Kizilcec R, Laine L, Mccall T, Shung D. Human-Algorithmic Interaction Using a Large Language Model-Augmented Artificial Intelligence Clinical Decision Support System. 2024, 1-20. DOI: 10.1145/3613904.3642024.Peer-Reviewed Original ResearchClinical decision support systemsHuman-computer interactionDecision support systemArtificial intelligenceAI-CDSSIntelligent clinical decision support systemSupport systemIntegration of artificial intelligenceHuman-algorithm interactionsEase-of-useLanguage modelHuman algorithmAI systemsSocio-technological challengesHealth-care providersMedical student participationQualitative themesClinical simulationClinical expertiseUpper gastrointestinal bleedingUsabilityBorderline decisionsLanguageClinical intuitionTrustMo1066 LARGE LANGUAGE MODEL-BASED SIMULATED PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING FOR MEDICAL EDUCATION – A PILOT STUDY WITH EMPATHGPT
Rajashekar N, Chan C, Laine L, Shung D. Mo1066 LARGE LANGUAGE MODEL-BASED SIMULATED PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING FOR MEDICAL EDUCATION – A PILOT STUDY WITH EMPATHGPT. Gastroenterology 2024, 166: s-933. DOI: 10.1016/s0016-5085(24)02628-3.Peer-Reviewed Original ResearchSu1979 GUTGPT: NOVEL LARGE LANGUAGE MODEL PIPELINE OUTPERFORMS OTHER LARGE LANGUAGE MODELS IN ACCURACY AND SIMILARITY TO INTERNATIONAL EXPERTS FOR GUIDELINE RECOMMENDED MANAGEMENT OF PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING
Giuffrè M, You K, Chung S, Kresevic S, Chan C, Saarinen T, Nakamura S, Laine L, Sung J, Garcia-Tsao G, Gralnek I, Barkun A, Sekhon J, Shung D. Su1979 GUTGPT: NOVEL LARGE LANGUAGE MODEL PIPELINE OUTPERFORMS OTHER LARGE LANGUAGE MODELS IN ACCURACY AND SIMILARITY TO INTERNATIONAL EXPERTS FOR GUIDELINE RECOMMENDED MANAGEMENT OF PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING. Gastroenterology 2024, 166: s-889-s-890. DOI: 10.1016/s0016-5085(24)02528-9.Peer-Reviewed Original Research407 IMPACT OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR UPPER GASTROINTESTINAL BLEEDING ON CLINICIAN TRUST AND LEARNING USING LARGE LANGUAGE MODELS: A RANDOMIZED PILOT SIMULATION STUDY
Chung S, Rajashekar N, Pu Y, Shin Y, Giuffrè M, Chan C, You K, Saarinen T, Hsiao A, Sekhon J, Wong A, Evans L, McCall T, Kizilcec R, Laine L, Shung D. 407 IMPACT OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR UPPER GASTROINTESTINAL BLEEDING ON CLINICIAN TRUST AND LEARNING USING LARGE LANGUAGE MODELS: A RANDOMIZED PILOT SIMULATION STUDY. Gastroenterology 2024, 166: s-95-s-96. DOI: 10.1016/s0016-5085(24)00715-7.Peer-Reviewed Original ResearchTu1649 SIMULATING THE PATIENT-PRACTITIONER RELATIONSHIP IN PATIENTS WITH IRRITABLE BOWEL SYNDROME WITH LARGE LANGUAGE MODELBASED TOOLS – A PROOF OF CONCEPT
Rajashekar N, Chan C, Deutsch J, Laine L, Shung D. Tu1649 SIMULATING THE PATIENT-PRACTITIONER RELATIONSHIP IN PATIENTS WITH IRRITABLE BOWEL SYNDROME WITH LARGE LANGUAGE MODELBASED TOOLS – A PROOF OF CONCEPT. Gastroenterology 2024, 166: s-1364. DOI: 10.1016/s0016-5085(24)03586-8.Peer-Reviewed Original Research543 IDENTIFYING OVERT SIGNS OF ACUTE GASTROINTESTINAL BLEEDING IN THE ELECTRONIC HEALTH RECORD WITH LARGE LANGUAGE MODELS
Zheng N, Keloth V, You K, Li D, Xu H, Laine L, Shung D. 543 IDENTIFYING OVERT SIGNS OF ACUTE GASTROINTESTINAL BLEEDING IN THE ELECTRONIC HEALTH RECORD WITH LARGE LANGUAGE MODELS. Gastroenterology 2024, 166: s-124-s-125. DOI: 10.1016/s0016-5085(24)00776-5.Peer-Reviewed Original ResearchTu2035 DEEP LEARNING TO CLASSIFY ENDOSCOPIC STIGMATA FOR PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING
Dupont J, Giuffrè M, Zhong J, You K, Laine L, Shung D. Tu2035 DEEP LEARNING TO CLASSIFY ENDOSCOPIC STIGMATA FOR PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING. Gastroenterology 2024, 166: s-1502. DOI: 10.1016/s0016-5085(24)03892-7.Peer-Reviewed Original Research1244 AUTOMATED IDENTIFICATION OF RECURRENT GASTROINTESTINAL BLEEDING USING ELECTRONIC HEALTH RECORDS AND LARGE LANGUAGE MODELS
Zheng N, Keloth V, You K, Li D, Xu H, Laine L, Shung D. 1244 AUTOMATED IDENTIFICATION OF RECURRENT GASTROINTESTINAL BLEEDING USING ELECTRONIC HEALTH RECORDS AND LARGE LANGUAGE MODELS. Gastroenterology 2024, 166: s-292. DOI: 10.1016/s0016-5085(24)01152-1.Peer-Reviewed Original ResearchTu1390 VALIDATION OF A MULTIMODAL MACHINE LEARNING MODEL FOR POST-ENDOSCOPIC RISK STRATIFICATION IN ACUTE UPPER GASTROINTESTINAL BLEEDING
Dupont J, Giuffrè M, Zheng N, Laine L, Shung D. Tu1390 VALIDATION OF A MULTIMODAL MACHINE LEARNING MODEL FOR POST-ENDOSCOPIC RISK STRATIFICATION IN ACUTE UPPER GASTROINTESTINAL BLEEDING. Gastroenterology 2024, 166: s-1327-s-1328. DOI: 10.1016/s0016-5085(24)03494-2.Peer-Reviewed Original ResearchMo1281 COMPARISON OF LOCAL INVESTIGATOR-REPORTED VS CENTRALLY ADJUDICATED LOS ANGELES GRADES OF EROSIVE ESOPHAGITIS IN PATIENTS SCREENED FOR PARTICIPATION IN A RANDOMIZED TRIAL
Spechler S, Laine L, Devault K, Smith N, Leifke E, Nabulsi A, Hunt B, Katz P. Mo1281 COMPARISON OF LOCAL INVESTIGATOR-REPORTED VS CENTRALLY ADJUDICATED LOS ANGELES GRADES OF EROSIVE ESOPHAGITIS IN PATIENTS SCREENED FOR PARTICIPATION IN A RANDOMIZED TRIAL. Gastroenterology 2024, 166: s-1011-s-1012. DOI: 10.1016/s0016-5085(24)02800-2.Peer-Reviewed Original Research864 VONOPRAZAN FOR THE TREATMENT OF HEARTBURN IN NON-EROSIVE REFLUX DISEASE: A RANDOMIZED TRIAL
Laine L, Spechler S, Yadlapati R, Schnoll-Sussman F, Smith N, Leifke E, Harris T, Hunt B, Fass R, Katz P. 864 VONOPRAZAN FOR THE TREATMENT OF HEARTBURN IN NON-EROSIVE REFLUX DISEASE: A RANDOMIZED TRIAL. Gastroenterology 2024, 166: s-198. DOI: 10.1016/s0016-5085(24)00949-1.Peer-Reviewed Original ResearchLetter to the Editor: Endoscopy for potential variceal bleeding within 12 hours—Not so fast!
Laine L, Barkun A, Leontiadis G. Letter to the Editor: Endoscopy for potential variceal bleeding within 12 hours—Not so fast! Hepatology 2024, 80: e15-e16. PMID: 38607699, DOI: 10.1097/hep.0000000000000876.Peer-Reviewed Original ResearchImpact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse in integrated healthcare system: difference-in-difference study
Kurlander J, Laine L, Kim H, Roberts C, Saffar D, Myers A, Holleman R, Gao Y, Shank M, Nelson R, Forman J, Helfrich C, Krein S, Saini S, Yang Y. Impact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse in integrated healthcare system: difference-in-difference study. The BMJ 2024, 385: e076484. PMID: 38604668, PMCID: PMC11007585, DOI: 10.1136/bmj-2023-076484.Peer-Reviewed Original ResearchConceptsPrimary care visitsProton pump inhibitors prescriptionUpper gastrointestinal diagnosesMulticomponent interventionCare visitsHealthcare systemHospital admissionUS Veterans Affairs Healthcare SystemVeterans Affairs Healthcare SystemAbsolute reductionGastrointestinal diagnosesIntegrated healthcare systemProton pump inhibitor overuseReducing proton-pump inhibitorDifference-in-differences studyProton pump inhibitorsPercentage of patientsProton pump inhibitor useAcid peptic diseaseElectronic prescribingPrimary careHealthcare utilizationIntervention sitesPPI prescriptionsOlder adultsReview article: Upper gastrointestinal bleeding – review of current evidence and implications for management
Shung D, Laine L. Review article: Upper gastrointestinal bleeding – review of current evidence and implications for management. Alimentary Pharmacology & Therapeutics 2024, 59: 1062-1081. PMID: 38517201, DOI: 10.1111/apt.17949.Peer-Reviewed Original ResearchUpper gastrointestinal bleedingManagement of upper gastrointestinal bleedingAcute upper gastrointestinal bleedingPeptic ulcer diseaseOver-the-scope clipPre-endoscopicVariceal bleedingManagement of acute upper gastrointestinal bleedingTreated with prophylactic antibioticsTransjugular intrahepatic portosystemic shuntUpper gastrointestinal bleeding patientsRed blood cell transfusion policyPre-endoscopic managementHigh-risk stigmataSeverity of bleedingEarly enteral feedingHigh-risk patientsMeta-analysisIntrahepatic portosystemic shuntProton pump inhibitorsEvidence-based updateOver-the-scopeHospital-based carePhase of careRandom-effects methodAGA Clinical Practice Update on High-Quality Upper Endoscopy: Expert Review
Nagula S, Parasa S, Laine L, Shah S. AGA Clinical Practice Update on High-Quality Upper Endoscopy: Expert Review. Clinical Gastroenterology And Hepatology 2024, 22: 933-943. PMID: 38385942, DOI: 10.1016/j.cgh.2023.10.034.Peer-Reviewed Original ResearchClinical Practice UpdateAmerican Gastroenterological Association (AGA) Institute Clinical Practice UpdateUpper endoscopySurveillance intervalsPractice updateExpert reviewAGA Governing BoardConsensus-based expert opinionStandard biopsy protocolUpper endoscopic examinationPractice advice statementsPeer reviewUpper gastrointestinal mucosaInternational peer reviewAGA membershipBiopsy protocolSurveillance endoscopyDiagnostic yieldHistopathological resultsEndoscopic findingsRetroflexed viewCharacterization of abnormalitiesEndoscopic examinationEndoscopyAdequate visualizationChapter 2 Data access, data bias, data equity
Shung D, Laine L. Chapter 2 Data access, data bias, data equity. 2024, 13-26. DOI: 10.1016/b978-0-323-95068-8.00002-9.Peer-Reviewed Original Research