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Description
For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations

For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations are unknown. There were 1,722 patients discharged with a primary diagnosis of HF from an academic hospital between January 2005 and December 2007. Three hundred eighty-one patients experienced 566 AEs, classified into four categories: medication (43.9%), infection (18.9%), patient care (26.3%), or procedural (10.9%). Three distinct analyses were performed: 1) patient's perspective of SOPP reliability including cumulative distribution and hazard functions of time to AEs; 2) Cox proportional hazards model to determine independent patient-specific risk factors for AEs; and 3) hospital administration's perspective of SOPP reliability through three years of the study including cumulative distribution and hazard functions of time between AEs and moving range statistical process control (SPC) charts for days between failures of each type. This is the first study, to our knowledge, to consider reliability of SOPP from both the patient's and hospital administration's perspective. AE rates in hospitalized patients are similar to other recently published reports and did not improve during the study period. Operations research methodologies will be necessary to improve reliability of care delivered to hospitalized patients.
ContributorsHuddleston, Jeanne (Author) / Fowler, John (Thesis advisor) / Montgomery, Douglas C. (Thesis advisor) / Gel, Esma (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Mathematical modeling and decision-making within the healthcare industry have given means to quantitatively evaluate the impact of decisions into diagnosis, screening, and treatment of diseases. In this work, we look into a specific, yet very important disease, the Alzheimer. In the United States, Alzheimer’s Disease (AD) is the 6th leading

Mathematical modeling and decision-making within the healthcare industry have given means to quantitatively evaluate the impact of decisions into diagnosis, screening, and treatment of diseases. In this work, we look into a specific, yet very important disease, the Alzheimer. In the United States, Alzheimer’s Disease (AD) is the 6th leading cause of death. Diagnosis of AD cannot be confidently confirmed until after death. This has prompted the importance of early diagnosis of AD, based upon symptoms of cognitive decline. A symptom of early cognitive decline and indicator of AD is Mild Cognitive Impairment (MCI). In addition to this qualitative test, Biomarker tests have been proposed in the medical field including p-Tau, FDG-PET, and hippocampal. These tests can be administered to patients as early detectors of AD thus improving patients’ life quality and potentially reducing the costs of the health structure. Preliminary work has been conducted in the development of a Sequential Tree Based Classifier (STC), which helps medical providers predict if a patient will contract AD or not, by sequentially testing these biomarker tests. The STC model, however, has its limitations and the need for a more complex, robust model is needed. In fact, STC assumes a general linear model as the status of the patient based upon the tests results. We take a simulation perspective and try to define a more complex model that represents the patient evolution in time.

Specifically, this thesis focuses on the formulation of a Markov Chain model that is complex and robust. This Markov Chain model emulates the evolution of MCI patients based upon doctor visits and the sequential administration of biomarker tests. Data provided to create this Markov Chain model were collected by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The data lacked detailed information of the sequential administration of the biomarker tests and therefore, different analytical approaches were tried and conducted in order to calibrate the model. The resulting Markov Chain model provided the capability to conduct experiments regarding different parameters of the Markov Chain and yielded different results of patients that contracted AD and those that did not, leading to important insights into effect of thresholds and sequence on patient prediction capability as well as health costs reduction.



The data in this thesis was provided from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). ADNI investigators did not contribute to any analysis or writing of this thesis. A list of the ADNI investigators can be found at: http://adni.loni.usc.edu/about/governance/principal-investigators/ .
ContributorsCamarena, Raquel (Author) / Pedrielli, Giulia (Thesis advisor) / Li, Jing (Thesis advisor) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2018
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Description
The current Enterprise Requirements and Acquisition Model (ERAM), a discrete event simulation of the major tasks and decisions within the DoD acquisition system, identifies several what-if intervention strategies to improve program completion time. However, processes that contribute to the program acquisition completion time were not explicitly identified in the simulation

The current Enterprise Requirements and Acquisition Model (ERAM), a discrete event simulation of the major tasks and decisions within the DoD acquisition system, identifies several what-if intervention strategies to improve program completion time. However, processes that contribute to the program acquisition completion time were not explicitly identified in the simulation study. This research seeks to determine the acquisition processes that contribute significantly to total simulated program time in the acquisition system for all programs reaching Milestone C. Specifically, this research examines the effect of increased scope management, technology maturity, and decreased variation and mean process times in post-Design Readiness Review contractor activities by performing additional simulation analyses. Potential policies are formulated from the results to further improve program acquisition completion time.
ContributorsWorger, Danielle Marie (Author) / Wu, Teresa (Thesis director) / Shunk, Dan (Committee member) / Wirthlin, J. Robert (Committee member) / Industrial, Systems (Contributor) / Barrett, The Honors College (Contributor)
Created2013-05
Description

Medical recovery time continues to be a drawback for many medical diagnoses and procedures. Prolonged recovery affects all aspects of the population, and targets different avenues of everyday life. Avenues such as providing, attending a job, personal objectives in different ways and even their own well-being. To combat this one

Medical recovery time continues to be a drawback for many medical diagnoses and procedures. Prolonged recovery affects all aspects of the population, and targets different avenues of everyday life. Avenues such as providing, attending a job, personal objectives in different ways and even their own well-being. To combat this one area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. PRF, or platelet-rich fibrin, is the next generation treatment of platelet concentrate. PRF is a fibrin matrix composed of platelet cytokines, growth factors and cells used to help wound healing and tissue regeneration. The objective of this thesis is to investigate the potential recovery time difference with PRF incorporation for common medical procedures. The experimental group included three individuals who had PRF treatment at any point during any sort of medical operation. The control group included individuals who did not have PRF treatment at any point and also those who had no prior knowledge of this method of treatment. Results were mixed because of the variative behind the medical procedures. Through observation, PRF treatment improved tolerance of pain, well-being of patients and quality of recovery with three different domains of inquiry per patient testimony. This case-analysis of 6 patients is a preliminary study and therefore inconclusive. PRF is a promising approach and this study suggests that it could potentially be a new medical approach to treatment.

ContributorsBuch, Ajay (Author) / Kingsbury, Jeffrey (Thesis director) / Gaesser, Glenn (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
ContributorsMichels, Bailey (Author) / O'Flaherty, Katherine (Thesis director) / Rasmussen, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
ContributorsMichels, Bailey (Author) / O'Flaherty, Katherine (Thesis director) / Rasmussen, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
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Description
Nonalcoholic Steatohepatitis (NASH) is a severe form of Nonalcoholic fatty liverdisease, that is caused due to excessive calorie intake, sedentary lifestyle and in the absence of severe alcohol consumption. It is widely prevalent in the United States and in many other developed countries, affecting up to 25 percent of the population. Due to

Nonalcoholic Steatohepatitis (NASH) is a severe form of Nonalcoholic fatty liverdisease, that is caused due to excessive calorie intake, sedentary lifestyle and in the absence of severe alcohol consumption. It is widely prevalent in the United States and in many other developed countries, affecting up to 25 percent of the population. Due to being asymptotic, it usually goes unnoticed and may lead to liver failure if not treated at the right time. Currently, liver biopsy is the gold standard to diagnose NASH, but being an invasive procedure, it comes with it's own complications along with the inconvenience of sampling repeated measurements over a period of time. Hence, noninvasive procedures to assess NASH are urgently required. Magnetic Resonance Elastography (MRE) based Shear Stiffness and Loss Modulus along with Magnetic Resonance Imaging based proton density fat fraction have been successfully combined to predict NASH stages However, their role in the prediction of disease progression still remains to be investigated. This thesis thus looks into combining features from serial MRE observations to develop statistical models to predict NASH progression. It utilizes data from an experiment conducted on male mice to develop progressive and regressive NASH and trains ordinal models, ordered probit regression and ordinal forest on labels generated from a logistic regression model. The models are assessed on histological data collected at the end point of the experiment. The models developed provide a framework to utilize a non-invasive tool to predict NASH disease progression.
ContributorsDeshpande, Eeshan (Author) / Ju, Feng (Thesis advisor) / Wu, Teresa (Committee member) / Yan, Hao (Committee member) / Arizona State University (Publisher)
Created2021
Description

This research paper focuses on how the idea of suffering has evolved over time in the United States healthcare system. Different aspects like long vs short-term illnesses, bias, and more were inspected to determine how they play a part in increased or decreased patient suffering. The final determination of how

This research paper focuses on how the idea of suffering has evolved over time in the United States healthcare system. Different aspects like long vs short-term illnesses, bias, and more were inspected to determine how they play a part in increased or decreased patient suffering. The final determination of how suffering in the system has evolved and what to do with this information is also discussed.

ContributorsMichels, Bailey (Author) / O'Flaherty, Katherine (Thesis director) / Rasmussen, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
Description

This thesis explores the ethical implications of using facial recognition artificial intelligence (AI) technologies in medicine, with a focus on both the opportunities and challenges presented by the use of this technology in the diagnosis and treatment of rare genetic disorders. We highlight the positive outcomes of using AI in

This thesis explores the ethical implications of using facial recognition artificial intelligence (AI) technologies in medicine, with a focus on both the opportunities and challenges presented by the use of this technology in the diagnosis and treatment of rare genetic disorders. We highlight the positive outcomes of using AI in medicine, such as accuracy and efficiency in diagnosing rare genetic disorders, while also examining the ethical concerns including bias, misdiagnosis, the issues it may cause within patient-clinician relationships, misuses outside of medicine, and privacy. This paper draws on the opinions of medical providers and other professionals outside of medicine, which finds that while many are excited about the potential of AI to improve medicine, concerns remain about the ethical implications of these technologies. We discuss current legislation controlling the use of AI in healthcare and its ambiguity. Overall, this thesis highlights the need for further research and public discourse to address the ethical implications of using facial recognition and AI technologies in medicine, while also providing recommendations for its future use in medicine.

ContributorsVargas Jordan, Anna (Author) / Kohlenberg, Maiya (Co-author) / Martin, Thomas (Thesis director) / Sellner, Erin (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
Description
This paper explores the benefits reading and writing medical poetry can benefit preprofessional/medical students, physicians, and patients as a means to share the experiences they
encounter in the medical world. The concept for this paper originates from the idea of narrative
medicine as a way to foster relationships between physicians and patients

This paper explores the benefits reading and writing medical poetry can benefit preprofessional/medical students, physicians, and patients as a means to share the experiences they
encounter in the medical world. The concept for this paper originates from the idea of narrative
medicine as a way to foster relationships between physicians and patients through the sharing of
stories, or narratives, between the two parties. In efforts to help teach this skill, universities and
medical schools have begun to offer courses in the medical humanities. The goal of these courses
is to teach students how to develop the skills they need to empathize and learn from their
patients’ experiences. Paired with the traditional rigor of a science-based curriculum, the medical
humanities have become part of medical schools’ efforts to “train the whole physician.”
Medical poetry is an example of the types of humanities courses that can benefit students
interested in medicine. The history of medical poetry spans across decades of literary history.
Beginning with the early references of medicine from the ancient world to the contemporary
work of the present, poets of different backgrounds and histories are discussed. Research to
support the efficacy of medical poetry include studies done on how medical poetry has impacted
students, readers, and patients. Finally, the author’s experiences as both a pre-professional
student and patient are shared to further explore the benefits that reading, and writing can bring.
ContributorsVilla, Rosario Alicia (Author) / Dombroski, Rosemarie (Thesis director) / Hanlon, Christopher (Committee member) / College of Health Solutions (Contributor) / Department of English (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05