2024
Validation of an Electronic Health Record–Based Machine Learning Model Compared With 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 With Clinical Risk Scores for Gastrointestinal Bleeding. Gastroenterology 2024, 167: 1198-1212. PMID: 38971198, PMCID: PMC11493512, 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-risk
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 savings
2022
Disparities 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 ResearchTrends in characteristics, management, and outcomes of patients presenting with gastrointestinal bleeding to emergency departments in the United States from 2006 to 2019
Zheng NS, Tsay C, Laine L, Shung DL. Trends in characteristics, management, and outcomes of patients presenting with gastrointestinal bleeding to emergency departments in the United States from 2006 to 2019. Alimentary Pharmacology & Therapeutics 2022, 56: 1543-1555. PMID: 36173090, PMCID: PMC9669230, DOI: 10.1111/apt.17238.Peer-Reviewed Original ResearchConceptsGastrointestinal bleedingLength of stayEmergency departmentMultivariable analysisIncidence of GIBRed blood cell transfusionNationwide Emergency Department SampleBlood cell transfusionIncidence of patientsOutcomes of patientsSex-adjusted incidenceEmergency Department SampleCase fatality rateRecent epidemiologic studiesProportion of casesED dischargeMore comorbiditiesCell transfusionRBC transfusionMore patientsComorbid populationEpidemiological evaluationInpatient costsPrimary diagnosisEpidemiologic studies
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
2017
Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis
Hou LA, Laine L, Motamedi N, Sahakian A, Lane C, Buxbaum J. Optimal Timing of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis. Journal Of Clinical Gastroenterology 2017, 51: 534-538. PMID: 27875357, DOI: 10.1097/mcg.0000000000000763.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdolescentAdultAgedAged, 80 and overCholangiopancreatography, Endoscopic RetrogradeCholangitisFemaleHospitalizationHumansIntensive Care UnitsIntubation, IntratrachealLength of StayMaleMiddle AgedMultivariate AnalysisProspective StudiesTime FactorsTreatment OutcomeYoung AdultConceptsEndoscopic retrograde cholangiopancreatographyIntensive care unit admissionCare unit admissionLength of hospitalizationAcute cholangitisUnit admissionRetrograde cholangiopancreatographyFrequent intensive care unit admissionOptimal timingAdditional adverse outcomesCases of cholangitisProcedural adverse eventsDays of presentationVasopressor requirementVasopressor supportBiliary decompressionHospital stayVasopressor useSecondary outcomesAdverse eventsAntibiotic therapyPrimary outcomeEndotracheal intubationAdverse outcomesEmergency departmentRelationship of time to presentation after onset of upper GI bleeding with patient characteristics and outcomes: a prospective study
Laine L, Laursen SB, Dalton HR, Ngu JH, Schultz M, Stanley AJ. Relationship of time to presentation after onset of upper GI bleeding with patient characteristics and outcomes: a prospective study. Gastrointestinal Endoscopy 2017, 86: 1028-1037. PMID: 28396275, DOI: 10.1016/j.gie.2017.03.1549.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood TransfusionConfusionDuodenal DiseasesEsophageal DiseasesFemaleGlasgow Coma ScaleHematemesisHemoglobinsHemostasis, EndoscopicHumansLength of StayLethargyMaleMelenaMiddle AgedPatient Acceptance of Health CarePrognosisProspective StudiesSerum AlbuminStomach DiseasesStuporTime-to-TreatmentConceptsUpper GI bleedingPatient characteristicsHemoglobin levelsDecreased hemoglobin levelLikelihood of transfusionLower hemoglobin levelsSignificant independent factorsGI bleedingHospital daysConsecutive patientsUpper GIHemostatic interventionPoor outcomeProspective studyEmergency departmentRelationship of timeMental statusIndependent factorsPatientsMulti-national studyLogistic regressionMelenaOutcomesTransfusionHospital