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Artificial neural networks are algorithms that can be used to perform nonlinear statistical modeling and provide a new alternative to logistic regression, the most commonly used method for developing predictive models for dichotomous outcomes in medicine. Neural networks offer a number of advantages, including requiring less formal statistical training,(More)
BACKGROUND The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction. METHODS(More)
BACKGROUND Although mass screening for osteoporosis is not recommended among postmenopausal women, there is no consensus on which women should undergo testing for low bone mineral density. The objective of this study was to develop and validate a clinical tool to help clinicians identify which women are at increased risk for osteoporosis and should(More)
AIM This paper reports on structures and processes of hospital care influencing 30-day mortality for acute medical patients. BACKGROUND Wide variation in risk-adjusted 30-day hospital mortality rates for acute medical patients indicates that hospital structures and processes of care affect patient death. Because nurses provide the majority of care to(More)
BACKGROUND The safety and efficacy of drug-eluting stents (DES) among more generalized "real-world" patients than those enrolled in pivotal randomized controlled trials (RCTs) are controversial. We sought to perform a meta-analysis of DES studies to estimate the relative impact of DES versus bare metal stents (BMS) on safety and efficacy end points,(More)
BACKGROUND Most proton pump inhibitors inhibit the bioactivation of clopidogrel to its active metabolite. The clinical significance of this drug interaction is unknown. METHODS We conducted a population-based nested case-control study among patients aged 66 years or older who commenced clopidogrel between Apr. 1, 2002, and Dec. 31, 2007, following(More)
BACKGROUND Universal health care systems seek to ensure access to care on the basis of need rather than income and to improve the health status of all citizens. We examined the performance of the Canadian health system with respect to these goals in the province of Ontario by assessing the effects of neighborhood income on access to invasive cardiac(More)
BACKGROUND A multicenter population-based study was conducted to develop and validate a risk index for mortality, intensive care unit (ICU) length of stay, and postoperative length of stay after cardiac surgery. METHODS AND RESULTS Data were collected from 13,098 patients undergoing cardiac surgery between April 1, 1991, and March 31, 1993, at all nine(More)
CONTEXT A predictive model of mortality in heart failure may be useful for clinicians to improve communication with and care of hospitalized patients. OBJECTIVES To identify predictors of mortality and to develop and to validate a model using information available at hospital presentation. DESIGN, SETTING, AND PARTICIPANTS Retrospective study of 4031(More)
Patients with atrial fibrillation (AF) who have severe chronic kidney disease (CKD) have a higher risk for stroke and bleeding. AF is the most common cardiac arrhythmia and is an independent risk factor for a new stroke. Patients with AF who have severe CKD, which requires treatment with dialysis, have a 5-fold higher risk for a new stroke. AF is becoming(More)