Modelling the episodes of care for iron deficiency anemia patients in a secondary-care center using continuous-time multistate Markov chain.
Authors: Almilaji, O.
Journal: Saudi J Gastroenterol
Volume: 28
Issue: 2
Pages: 115-121
eISSN: 1998-4049
DOI: 10.4103/sjg.sjg_387_21
Abstract:BACKGROUND: Despite the high prevalence of gastro-intestinal (GI) cancer in iron deficiency anemia (IDA), some IDA patients do not complete all the necessary GI investigations at the initial referral. As a result, existing cancers are diagnosed at a later referral with worse prognosis. The potential to detect GI cancer early depends on minimizing the delay time spent between the two consecutive referrals, where a patient did not complete investigations at the first referral, but at the second is diagnosed with positive GI cancer. This retrospective longitudinal study aims to highlight the proper methods to model these referrals. METHODS: Using anonymized data of 168 episodes of care for IDA patients at an IDA clinic in a secondary care setting, continuous-time multi-state Markov chain is employed to determine the transition rates among three observed states for IDA patients at the IDA clinic, "incomplete investigations," "negative GI cancer," and "positive GI cancer" and to estimate the delay time. RESULTS: Once in the state of incomplete investigations, an estimated mean delay time of 3.1 years (95% CI: 1.2, 5) is spent before being diagnosed with positive GI cancer. The probability that a "positive GI diagnosis" is next after the state of "incomplete investigation" is 17%, compared with 11% when it is followed in the state of negative GI cancer. Defining the survival as the event of not being in the state of "positive GI cancer," the survival rate of IDA patients with negative GI cancer is always higher than those with incomplete investigations. Finally, being diagnosed with positive GI cancer is always preceded by the prediction of being considered "very high risk" at the earlier visit. CONCLUSION: A baseline model was proposed to represent episodes of care for IDA patients at a secondary care center. Preliminary results highlight the importance of completing the GI investigations, especially in IDA patients, who are at high risk of GI cancer and fit to go through the investigations.
https://eprints.bournemouth.ac.uk/36212/
https://eprints.bournemouth.ac.uk/36214/
Source: PubMed
Modelling the Episodes of Care for IDA Patients in a Secondary Care Centre Using Continuous-Time Multistate Markov Chain
Authors: Almilaji, O.
Journal: AMERICAN JOURNAL OF GASTROENTEROLOGY
Volume: 116
Pages: S605
eISSN: 1572-0241
ISSN: 0002-9270
https://eprints.bournemouth.ac.uk/36212/
https://eprints.bournemouth.ac.uk/36214/
Source: Web of Science (Lite)
Modelling the episodes of care for IDA patients in a secondary-care centre using continuous-time multistate Markov chain
Authors: Almilaji, O.
Journal: Saudi Journal of Gastroenterology
Publisher: Medknow Publications
ISSN: 1319-3767
Abstract:Background: Despite the high prevalence of gastro-intestinal (GI) cancer in iron deficiency anaemia (IDA), some IDA patients do not complete all the necessary GI investigations at the initial referral. As a result, existing cancers are diagnosed at a later referral with worse prognosis. The potential to detect GI cancer early depends on minimizing the delay time spent between the two consecutive referrals, where a patient did not complete investigations at the first referral, but at the second is diagnosed with positive GI cancer. This retrospective longitudinal study aims to highlight the proper methods to model these referrals.
Methods: Using anonymised data of 168 episodes of care for IDA patients at an IDA clinic in secondary care setting, continuous-time multi-state Markov chain is employed to determine the transition rates between three observed states for IDA patients at the IDA clinic; “incomplete investigations”, “negative GI cancer”, and “positive GI cancer” and to estimate the delay time.
Results: Once in the state of incomplete investigations, an estimated mean delay time of 3.1 years (95% CI: 1.2, 5) is spent before being diagnosed with positive GI cancer. The probability that the “positive GI diagnosis” is next after the state of “incomplete investigation” is 17% compared with 11% when it is followed the state of negative GI cancer. Defining the survival as the event of not being in the state of “positive GI cancer”, the survival rate of IDA patients with negative GI cancer is always higher than those with incomplete investigations. Finally, being diagnosed with positive GI cancer is always preceded by the prediction of being considered “very high risk” at the earlier visit.
Conclusion: A baseline model was proposed to represent episodes of care for IDA patients at a secondary care centre. Preliminary results highlight the importance of completing the GI investigations especially in IDA patients who are at high risk of GI cancer and fit enough to do the investigations.
https://eprints.bournemouth.ac.uk/36212/
https://eprints.bournemouth.ac.uk/36214/
Source: Manual
Modelling the episodes of care for iron deficiency anemia patients in a secondary-care center using continuous-time multistate Markov chain.
Authors: Almilaji, O.
Journal: Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
Volume: 28
Issue: 2
Pages: 115-121
eISSN: 1998-4049
ISSN: 1319-3767
DOI: 10.4103/sjg.sjg_387_21
Abstract:Background
Despite the high prevalence of gastro-intestinal (GI) cancer in iron deficiency anemia (IDA), some IDA patients do not complete all the necessary GI investigations at the initial referral. As a result, existing cancers are diagnosed at a later referral with worse prognosis. The potential to detect GI cancer early depends on minimizing the delay time spent between the two consecutive referrals, where a patient did not complete investigations at the first referral, but at the second is diagnosed with positive GI cancer. This retrospective longitudinal study aims to highlight the proper methods to model these referrals.Methods
Using anonymized data of 168 episodes of care for IDA patients at an IDA clinic in a secondary care setting, continuous-time multi-state Markov chain is employed to determine the transition rates among three observed states for IDA patients at the IDA clinic, "incomplete investigations," "negative GI cancer," and "positive GI cancer" and to estimate the delay time.Results
Once in the state of incomplete investigations, an estimated mean delay time of 3.1 years (95% CI: 1.2, 5) is spent before being diagnosed with positive GI cancer. The probability that a "positive GI diagnosis" is next after the state of "incomplete investigation" is 17%, compared with 11% when it is followed in the state of negative GI cancer. Defining the survival as the event of not being in the state of "positive GI cancer," the survival rate of IDA patients with negative GI cancer is always higher than those with incomplete investigations. Finally, being diagnosed with positive GI cancer is always preceded by the prediction of being considered "very high risk" at the earlier visit.Conclusion
A baseline model was proposed to represent episodes of care for IDA patients at a secondary care center. Preliminary results highlight the importance of completing the GI investigations, especially in IDA patients, who are at high risk of GI cancer and fit to go through the investigations.https://eprints.bournemouth.ac.uk/36212/
https://eprints.bournemouth.ac.uk/36214/
Source: Europe PubMed Central
Modelling the Episodes of Care for IDA Patients in a Secondary Care Centre Using Continuous-Time Multistate Markov Chain
Authors: Almilaji, O.
Publisher: The American Journal of Gastroenterology
https://eprints.bournemouth.ac.uk/36212/
https://eprints.bournemouth.ac.uk/36214/
Source: BURO EPrints
Modelling the episodes of care for iron deficiency anemia patients in a secondary-care center using continuous-time multistate Markov chain
Authors: Almilaji, O.
Journal: Saudi journal of gastroenterology
Volume: 28
Issue: 2
Pages: 115-121
ISSN: 1319-3767
Abstract:Background: Despite the high prevalence of gastro-intestinal (GI) cancer in iron deficiency anaemia (IDA), some IDA patients do not complete all the necessary GI investigations at the initial referral. As a result, existing cancers are diagnosed at a later referral with worse prognosis. The potential to detect GI cancer early depends on minimizing the delay time spent between the two consecutive referrals, where a patient did not complete investigations at the first referral, but at the second is diagnosed with positive GI cancer. This retrospective longitudinal study aims to highlight the proper methods to model these referrals. Methods: Using anonymised data of 168 episodes of care for IDA patients at an IDA clinic in secondary care setting, continuous-time multi-state Markov chain is employed to determine the transition rates between three observed states for IDA patients at the IDA clinic; “incomplete investigations”, “negative GI cancer”, and “positive GI cancer” and to estimate the delay time. Results: Once in the state of incomplete investigations, an estimated mean delay time of 3.1 years (95% CI: 1.2, 5) is spent before being diagnosed with positive GI cancer. The probability that the “positive GI diagnosis” is next after the state of “incomplete investigation” is 17% compared with 11% when it is followed the state of negative GI cancer. Defining the survival as the event of not being in the state of “positive GI cancer”, the survival rate of IDA patients with negative GI cancer is always higher than those with incomplete investigations. Finally, being diagnosed with positive GI cancer is always preceded by the prediction of being considered “very high risk” at the earlier visit. Conclusion: A baseline model was proposed to represent episodes of care for IDA patients at a secondary care centre. Preliminary results highlight the importance of completing the GI investigations especially in IDA patients who are at high risk of GI cancer and fit enough to do the investigations.
https://eprints.bournemouth.ac.uk/36212/
https://eprints.bournemouth.ac.uk/36214/
Source: BURO EPrints