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1.
《Vaccine》2016,34(51):6626-6633
BackgroundSafety signal detection in spontaneous reporting system databases and electronic healthcare records is key to detection of previously unknown adverse events following immunization. Various statistical methods for signal detection in these different datasources have been developed, however none are geared to the pediatric population and none specifically to vaccines. A reference set comprising pediatric vaccine-adverse event pairs is required for reliable performance testing of statistical methods within and across data sources.MethodsThe study was conducted within the context of the Global Research in Paediatrics (GRiP) project, as part of the seventh framework programme (FP7) of the European Commission. Criteria for the selection of vaccines considered in the reference set were routine and global use in the pediatric population. Adverse events were primarily selected based on importance. Outcome based systematic literature searches were performed for all identified vaccine-adverse event pairs and complemented by expert committee reports, evidence based decision support systems (e.g. Micromedex), and summaries of product characteristics. Classification into positive (PC) and negative control (NC) pairs was performed by two independent reviewers according to a pre-defined algorithm and discussed for consensus in case of disagreement.ResultsWe selected 13 vaccines and 14 adverse events to be included in the reference set. From a total of 182 vaccine-adverse event pairs, we classified 18 as PC, 113 as NC and 51 as unclassifiable. Most classifications (91) were based on literature review, 45 were based on expert committee reports, and for 46 vaccine-adverse event pairs, an underlying pathomechanism was not plausible classifying the association as NC.ConclusionA reference set of vaccine-adverse event pairs was developed. We propose its use for comparing signal detection methods and systems in the pediatric population.  相似文献   
2.
ObjectivesThe aim of this study was to report 1-year clinical outcomes following commercial transcatheter left atrial appendage occlusion (LAAO) in the United States.BackgroundThe National Cardiovascular Data Registry LAAO Registry was initiated to meet a condition of Medicare coverage and allow the assessment of clinical outcomes. The 1-year rates of thromboembolic events after transcatheter LAAO in such a large cohort of “real-world” patients have not been previously reported.MethodsPatients entered into the National Cardiovascular Data Registry LAAO Registry for a Watchman procedure between January 1, 2016, and December 31, 2018, were included. The primary endpoint was ischemic stroke. Key secondary endpoints included the rate of ischemic stroke or systemic embolism, mortality, and major bleeding. Major bleeding was defined as any bleeding requiring hospitalization, and/or causing a decrease in hemoglobin level > 2g/dL, and/or requiring blood transfusion that was not hemorrhagic stroke. The Kaplan-Meier method was used for 1-year estimates of cumulative event rates.ResultsThe study population consisted of 36,681 patients. The mean age was 76.0 ± 8.1 years, the mean CHA2DS2-VASc score was 4.8 ± 1.5, and the mean HAS-BLED score was 3.0 ± 1.1. Prior stroke was present in 25.5%, clinically relevant bleeding in 69.5%, and intracranial bleeding in 11.9%. Median follow-up was 374 days (IQR: 212-425 days). The Kaplan-Meier–estimated 1-year rate of ischemic stroke was 1.53% (95% CI: 1.39%-1.69%), the rate of ischemic stroke or systemic embolism was 2.19% (95% CI: 2.01%-2.38%), and the rate of mortality was 8.52% (95% CI: 8.19%-8.87%). The 1-year estimated rate of major bleeding was 6.93% (95% CI: 6.65%-7.21%). Most bleeding events occurred between discharge and 45 days following the procedure.ConclusionsThis study characterizes important outcomes in a national cohort of patients undergoing transcatheter LAAO in the United States. Clinicians and patients can integrate these data in shared decision making when considering this therapy.  相似文献   
3.

Objective

To determine whether differences in combination DTaP vaccine types at 2, 4 and 6?months of age were associated with mortality (all-cause or non-specific), within 30?days of vaccination.

Design

Observational nationwide cohort study.

Setting

Linked population data from the Australian Childhood Immunisation Register and National Death Index.

Participants

Australian infants administered a combination trivalent, quadrivalent or hexavalent DTaP vaccine (DTaP types) between January 1999 and December 2010 at 2, 4 and 6?months as part of the primary vaccination series. The study population included 2.9, 2.6, & 2.3?million children in the 2, 4 and 6?month vaccine cohorts, respectively.

Main outcome measures

Infants were evaluated for the primary outcome of all-cause mortality within 30?days. A secondary outcome was non-specific mortality (unknown cause of death) within 30?days of vaccination. Non-specific mortality was defined as underlying or other cause of death codes, R95 ‘Sudden infant death syndrome’, R96 ‘Other sudden death, cause unknown’, R98 ‘Unattended death’, R99 ‘Other ill-defined and unspecified cause of mortality’ or where no cause of death was recorded.

Results

The rate of 30?day all-cause mortality was low and declined from 127.4 to 59.3 deaths per 100,000 person-years between 2 and 6?month cohorts. When compared with trivalent DTaP vaccines, no elevated risk in all-cause or non-specific mortality was seen with any quadrivalent or hexavalent DTaP vaccines, for any cohort.

Conclusion

Use of routine DTaP combination vaccines with differing disease antigens administered during the first six months of life is not associated with infant mortality.  相似文献   
4.
评价天津市各辖区基本公共卫生服务的资源配置效率,寻求有效的资源配置措施和方法,为进一步优化卫生资源配置提供参考依据。方法利用数据包络分析,对天津市16辖区的基本公共卫生服务进行效率评价。结果天津市基本公共卫生服务的资源配置效率整体不高,仅有5辖区达到了规模最优,多数区非DEA有效,且投入过剩与产出不足并存。结论为了达到最优的基本公共卫生服务效率,政府及各级基本公共卫生服务机构必须有效地完善、落实相关政策,优化资源投入结构,统筹地区差异,加强资源供给管理,提高资源利用效率。  相似文献   
5.
Animal behaviour can be viewed as a stream of elements, which, once accurately described, can be counted and timed. Data acquisition techniques and tools are reviewed, and some strategies for collection and analysis of data using PC computers are suggested. Automated instruments are not satisfactory for the study of complex behaviour and as such systemic observation remains irreplaceable. IBM PC-type computers, with a wide range of analytical software (e.g., spreadsheets, statistical packages, technical graphics), are practical for data acquisition. Several systems which can satisfy different applications are reviewed. Some systems can communicate with a videorecorder, a facility which remarkably increases the accuracy of measurement; this is essential for meaningful analyses of the internal structure of behavioural streams (sequences, time patterns) or communication processes. The power of new tools enables behavioural measurement with the necessary complexity to allow a whole new set of questions to be addressed. However, it also increases demands for meaningful content and analysis of data.  相似文献   
6.
结合计算法和单一酶免法测定血清游离睾酮结果比较   总被引:3,自引:0,他引:3  
目的 探寻测定血清游离睾酮 (FT)浓度的准确方法。 方法  12 9例 45岁以上健康男性 ,按年龄分为 4组 ,收集血清标本 -40℃冻存。酶标免疫方法同批测定FT ,同时测定总睾酮 (T)和性激素结合球蛋白 (SHBG)并代入Vermeulen公式计算 :FT =T -2 3 .43FTSHBG -(T -2 3 .43FT) × 10 - 9mol/L。对两种方法测定结果进行统计学比较。 结果  12 9例标本中酶免法FT为 (46.69± 2 1.79)pmol/L ,计算法为 (3 96.3 0± 3 17.0 4)pmol/L ,t =13 .0 1,P <0 .0 1,差异有非常显著性意义。两种方法测定FT浓度各年龄组间差异均有非常显著性意义 (P <0 .0 1) ;与年龄相关分析差异均有非常显著性意义 (P <0 .0 1) ,相关程度计算法大于酶免法。FT/T平均百分数酶免法为 0 .2 3 % ,计算法为 1.42 %。 结论 结合计算法检测FT浓度较酶免法更科学、正确 ,更适用于老年男子部分性雄激素缺乏综合征 (PADAM )的诊断  相似文献   
7.
可视化技术及其在抗击SARS中的应用   总被引:1,自引:0,他引:1  
本文主要介绍了可视化技术,其中重点阐述了科学计算可视化、信息可视化和地学可视化,最后总结了可视化技术在这次抗击非典型肺炎中所起到的重要作用.  相似文献   
8.
During the last decade, the quality of MR angiograms has risen substantially and their clinical utility has been demonstrated progressively. This acceptance has created a need for tools with which to summarize and display the information available. We have used a model-based segmentation technique to extract vascular morphology and local flow parameters from phase contrast MR angiograms. A multiresolution data structure is used as the basis of recursive decision-making to identify regions of blood flow. The resulting data representation allows more efficient data handling in subsequent processing and visualization and is directly applicable to the creation of a connected graph model of vascular regions. We describe this flow feature extraction algorithm and demonstrate the utility of the results.  相似文献   
9.
本文介绍了1种由BCM-80单板机到AppleⅡ微机的图象数据传输方法。这种方法以盒式磁带作为传输工具,并采用AppleⅡ的磁带记录格式将由BCM-80所采集的同位素扫描图象数据传送到AppleⅡ微机之中,进行分析处理,然后输出1幅静止的易于识别和诊断的图象。此种方法不需要增加任何硬件,具有简单、可靠、传输速度快等优点。  相似文献   
10.
目的阐述在结直肠肿瘤多学科协作(MDT)诊治模式下,如何构建数据体系及其运作策略。方法阐明构建数据体系的原因,结合实践描述结直肠肿瘤数据体系的基本构成及如何支持数据体系的运行,探讨结直肠肿瘤MDT数据体系的价值反馈,并提出对数据体系建立未来的展望。结果通过会诊、随访、院内临床的支持及合理地实现MDT模式中信息化流程的建设,数据体系运行能正常进行。结论数据体系作为整个结直肠肿瘤MDT项目的基础,能够通过医疗模式的改变表现出医疗价值和社会价值。  相似文献   
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