Nicholas E. Ingraham
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View article: The Epidemiology of ICU Readmissions Across Ten Health Systems
The Epidemiology of ICU Readmissions Across Ten Health Systems Open
ICU readmissions remain a critical concern, carrying increased morbidity, mortality, and cost. We examined the epidemiology of unplanned ICU readmissions across 19 hospitals in the Common Longitudinal ICU data Format (CLIF) Consortium from…
View article: Variability in First Academic Medicine Job Offers in Pulmonary and Critical Care Medicine
Variability in First Academic Medicine Job Offers in Pulmonary and Critical Care Medicine Open
Background: A minority of Pulmonary and Critical Care Medicine (PCCM) graduates pursue careers in academic medicine. Although compensation is only a portion of the career decision, job negotiations remain shrouded in ambiguity and inconsis…
View article: Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation
Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation Open
Objective Use of prone positioning increased among mechanically ventilated patients during the COVID-19 pandemic, but it is unknown whether implementation of this life-saving intervention was sustained. Thus, we aimed to evaluate peri-pand…
View article: A comparative analysis of large language models versus traditional information extraction methods for real-world evidence of patient symptomatology in acute and post-acute sequelae of SARS-CoV-2
A comparative analysis of large language models versus traditional information extraction methods for real-world evidence of patient symptomatology in acute and post-acute sequelae of SARS-CoV-2 Open
Background Patient symptoms, crucial for disease progression and diagnosis, are often captured in unstructured clinical notes. Large language models (LLMs) offer potential advantages in extracting patient symptoms compared to traditional r…
View article: Correction: A common longitudinal intensive care unit data format (CLIF) for critical illness research
Correction: A common longitudinal intensive care unit data format (CLIF) for critical illness research Open
View article: A common longitudinal intensive care unit data format (CLIF) for critical illness research
A common longitudinal intensive care unit data format (CLIF) for critical illness research Open
View article: Hospital and Temporal Variations in Limitations of Care Among Hospitalized Patients with COVID-19: A VIRUS Registry Retrospective Cohort Study
Hospital and Temporal Variations in Limitations of Care Among Hospitalized Patients with COVID-19: A VIRUS Registry Retrospective Cohort Study Open
After adjusting for patient-level factors, we report significant inter-hospital but no temporal variation in life-support limitation upon admission with COVID-19. Future studies should investigate specific practices that led to health care…
View article: Using Electronic Health Records to Identify the Daily Primary Provider During Hospitalization
Using Electronic Health Records to Identify the Daily Primary Provider During Hospitalization Open
OBJECTIVES: Providers vary in their impact on clinical outcomes, but this is rarely accounted for in healthcare research. By failing to identify the provider responsible for a patient’s care, investigators miss an opportunity to account fo…
View article: Comparison of six natural language processing approaches to assessing firearm access in Veterans Health Administration electronic health records
Comparison of six natural language processing approaches to assessing firearm access in Veterans Health Administration electronic health records Open
Objective Access to firearms is associated with increased suicide risk. Our aim was to develop a natural language processing approach to characterizing firearm access in clinical records. Materials and Methods We used clinical notes from 3…
View article: Senolytics To slOw Progression of Sepsis (STOP-Sepsis) in elderly patients: Study protocol for a multicenter, randomized, adaptive allocation clinical trial
Senolytics To slOw Progression of Sepsis (STOP-Sepsis) in elderly patients: Study protocol for a multicenter, randomized, adaptive allocation clinical trial Open
View article: Comparison of Large Language Models Versus Traditional Information Extraction Methods for Real World Evidence of Patient Symptomatology in Acute and Post-Acute Sequelae of SARS-CoV-2
Comparison of Large Language Models Versus Traditional Information Extraction Methods for Real World Evidence of Patient Symptomatology in Acute and Post-Acute Sequelae of SARS-CoV-2 Open
Patient symptoms play a critical role in disease progression and diagnosis, yet they are most often captured in unstructured clinical notes. This study explores use of large language models (LLMs) for extracting patient symptoms from clini…
View article: A Common Longitudinal Intensive Care Unit data Format (CLIF) to enable multi-institutional federated critical illness research
A Common Longitudinal Intensive Care Unit data Format (CLIF) to enable multi-institutional federated critical illness research Open
Background Critical illness, or acute organ failure requiring life support, threatens over five million American lives annually. Electronic health record (EHR) data are a source of granular information that could generate crucial insights …
View article: mTOR inhibition in COVID‐19: A commentary and review of efficacy in RNA viruses
mTOR inhibition in COVID‐19: A commentary and review of efficacy in RNA viruses Open
In this commentary, we shed light on the role of the mammalian target of rapamycin (mTOR) pathway in viral infections. The mTOR pathway has been demonstrated to be modulated in numerous RNA viruses. Frequently, inhibiting mTOR results in s…
View article: Author Correction: Development of a proteomic signature associated with severe disease for patients with COVID-19 using data from 5 multicenter, randomized, controlled, and prospective studies
Author Correction: Development of a proteomic signature associated with severe disease for patients with COVID-19 using data from 5 multicenter, randomized, controlled, and prospective studies Open
View article: Favorable Antiviral Effect of Metformin on SARS-CoV-2 Viral Load in a Randomized, Placebo-Controlled Clinical Trial of COVID-19
Favorable Antiviral Effect of Metformin on SARS-CoV-2 Viral Load in a Randomized, Placebo-Controlled Clinical Trial of COVID-19 Open
Background Metformin has antiviral activity against RNA viruses including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The mechanism appears to be suppression of protein translation via targeting the host mechanistic targe…
View article: Building to learn: Information technology innovations to enable rapid pragmatic evaluation in a learning health system
Building to learn: Information technology innovations to enable rapid pragmatic evaluation in a learning health system Open
Background Learning health systems (LHSs) iteratively generate evidence that can be implemented into practice to improve care and produce generalizable knowledge. Pragmatic clinical trials fit well within LHSs as they combine real‐world da…
View article: Acute Appendicitis Treatment Strategies and Mortality Based on Critical Illness on Admission: An Observational Study
Acute Appendicitis Treatment Strategies and Mortality Based on Critical Illness on Admission: An Observational Study Open
Background: Trials have shown non-inferiority of non-operative management (NOM) for appendicitis, although critically ill patients have been often excluded. The purpose of this study is to evaluate surgical versus NOM outcome…
View article: A Symptom-Based Natural Language Processing Surveillance Pipeline for Post-COVID-19 Patients
A Symptom-Based Natural Language Processing Surveillance Pipeline for Post-COVID-19 Patients Open
Post-acute sequelae of SARS CoV-2 (PASC) are a group of conditions in which patients previously infected with COVID-19 experience symptoms weeks/months post-infection. PASC has substantial societal burden, including increased healthcare co…
View article: Development of a proteomic signature associated with severe disease for patients with COVID-19 using data from 5 multicenter, randomized, controlled, and prospective studies
Development of a proteomic signature associated with severe disease for patients with COVID-19 using data from 5 multicenter, randomized, controlled, and prospective studies Open
View article: Ventilator-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) Pneumonia in a Patient with a Negative MRSA Nasal Swab
Ventilator-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) Pneumonia in a Patient with a Negative MRSA Nasal Swab Open
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is associated with high morbidity and mortality. Recently, MRSA testing by nasal swab has been utilized to "exclude" pneumonia caused by MRSA, given its high negative-…
View article: Prediction of In-hospital Mortality Among Intensive Care Unit Patients Using Modified Daily Laboratory-based Acute Physiology Score, Version 2
Prediction of In-hospital Mortality Among Intensive Care Unit Patients Using Modified Daily Laboratory-based Acute Physiology Score, Version 2 Open
Background: Mortality prediction for intensive care unit (ICU) patients frequently relies on single ICU admission acuity measures without accounting for subsequent clinical changes. Objective: Evaluate novel models incorporating modified a…
View article: Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial
Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial Open
View article: Predictors of discharge disposition and mortality following hospitalization with SARS-CoV-2 infection
Predictors of discharge disposition and mortality following hospitalization with SARS-CoV-2 infection Open
Importance The SARS-CoV-2 pandemic has overwhelmed hospital capacity, prioritizing the need to understand factors associated with type of discharge disposition. Objective Characterization of disposition associated factors following SARS-Co…
View article: Proteomic pathways associated with developing severe disease for patients with COVID-19: A biologic analysis of data from two multicenter randomized controlled trials encompassing 13 U.S. hospitals
Proteomic pathways associated with developing severe disease for patients with COVID-19: A biologic analysis of data from two multicenter randomized controlled trials encompassing 13 U.S. hospitals Open
View article: Prediction of in-hospital mortality among intensive care unit patients using modified daily Laboratory-based Acute Physiology Scores, version 2 (LAPS2)
Prediction of in-hospital mortality among intensive care unit patients using modified daily Laboratory-based Acute Physiology Scores, version 2 (LAPS2) Open
Background Mortality prediction for intensive care unit (ICU) patients frequently relies on single acuity measures based on ICU admission physiology without accounting for subsequent clinical changes. Objectives Evaluate novel models incor…
View article: Impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination and Booster on Coronavirus Disease 2019 (COVID-19) Symptom Severity Over Time in the COVID-OUT Trial
Impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination and Booster on Coronavirus Disease 2019 (COVID-19) Symptom Severity Over Time in the COVID-OUT Trial Open
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to sev…
View article: Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19 Open
None of the three medications that were evaluated prevented the occurrence of hypoxemia, an emergency department visit, hospitalization, or death associated with Covid-19. (Funded by the Parsemus Foundation and others; COVID-OUT ClinicalTr…
View article: Re-Aiming Equity Evaluation in Clinical Decision Support
Re-Aiming Equity Evaluation in Clinical Decision Support Open
Objective: We critically evaluated the surgical literature to explore the prevalence and describe how equity assessments occur when using clinical decision support systems. Background: Clinical decision support (CDS) systems are increasing…
View article: Performance of a Chest Radiograph AI Diagnostic Tool for COVID-19: A Prospective Observational Study
Performance of a Chest Radiograph AI Diagnostic Tool for COVID-19: A Prospective Observational Study Open
AI-based tools have not yet reached full diagnostic potential for COVID-19 and underperform compared with radiologist prediction.Keywords: Diagnosis, Classification, Application Domain, Infection, Lung Supplemental material is av…
View article: Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study
Predictors of Postacute Sequelae of COVID-19 Development and Rehabilitation: A Retrospective Study Open
Patients with PASC had higher rehabilitation utilization. We identified several clinical and demographic factors associated with the development of PASC and rehabilitation utilization.