Connect with us

Health

Can artificial intelligence help measure opioid risks?

Published

 on

Researchers in Alberta are experimenting with artificial intelligence to measure the risks of prescription opioids amid the ongoing drug overdose crisis across Canada.

While doctors have a set protocol to identify patients at risk of opioid addiction, Dr. Dean Eurich said machine learning “could do a better job” of pinning down who is most susceptible.

The AI-assisted system could provide an additional “level of comfort to clinicians … (knowing) there are also other supports they can use to help (in) making sure the patient is getting the right drug at the right time,” said Eurich, program director for the clinical epidemiology program at the University of Alberta.

With this tool, physicians could predict the impacts of a prescription opioid on patients and save them from unnecessary emergency department visits or even death within 30 days of starting the medication.

Eurich was lead investigator on research published in December with JAMA Network, which analyzed medical data of more than 850,000 Albertans anonymously and predicted the best outcomes for the patients.

The data sets were mainly provided by Alberta Health.

Dr. Fizza Gilani of the College of Physicians and Surgeons of Alberta said machine learning could be an effective way to reduce hospitalizations and morbidity for patients once integrated in the health system.

“The model (could) predict risks of hospitalization,” said Gilani, who is the program manager of prescribing, analytics and the tracked prescription program at the college.

At times, she added, current methods don’t predict the origins of risk and the medical solutions could be more complicated than reducing a patient’s opioid dose.

The AI system was fed with various health factors to determine risks to a patient, including the history of injury, obesity, depression, diabetes, fluid disorder and psychosis. These were combined with diagnoses from doctors, health-care visits and information including where the patient lives.

“The idea is not to make physicians stop prescribing opioids, (but) to minimize the risk after the opioid exposure,” said Gilani.

The researchers looked at about three million opioid prescriptions a year from various medical professionals — doctors, nurse practitioners, dentists — to more than 600,000 patients in Alberta. Those who had cancer or were receiving palliative care were excluded.

Eurich said 20 per cent of patients were using opioids with other high-risk drugs, “increasing the risk of adverse outcome.”

Over the years, people’s interaction with the health system has become more complex, demanding an efficient approach to moving through the health-care system, Eurich said.

“As a human, I can look at a couple of dozen variables and predict outcomes, but we’re finding that’s just not enough.”

He said the machine learning takes a different approach, building systematic models with a nuanced set of data, including various key factors, and finding the combinations predicting the best outcomes for a patient.

Eurich, who has been working on AI predictions for more than three years, said the system can “predict correctly (for) four out of every five patients.” A patient identified as high-risk would have a higher chance of being hospitalized within the first 30 days of prescribing the drug, according to the machine.

He added that AI-powered systems could also rapidly adapt to the changing environment —  for instance, a sudden spike in opioid-related death during the pandemic.

The goal, Eurich said, is to “reduce the risk of patients who are using high-risk medications that we know can result in poor outcomes.”

Researchers will soon be testing the AI system with real-time data, Eurich said. They will also look into whether the system could limit long-term use of high-dose opioids among patients.

One advocacy group thinks the machine won’t help with the opioid crisis in Alberta.

Moms Stop the Harm co-founder Petra Schulz said most of opioid-related deaths in the province are fuelled by street drugs and not prescription opioids.

“This kind of AI could make the safer alternatives even less available,” she said. “It’s like you’re doing detective work and wanting to figure out what is not going right for the patient instead of developing a trusting doctor-patient relationship, which allows the patient to (speak) openly.”

Gilani agreed with Schulz’s observation on the opioid crisis but said there is an “indirect linkage” between a host of factors fed into the AI system and that the tool could help in reducing those deaths based on the data.

Eurich said a “good portion” of poor outcomes related to opioids is not fuelled by street drugs, but by prescription use — particularly in the beginning.

He said patients continue to get exposed to opioids for pain medication and eventually start using the health system to “doctor shop (and) obtain massive quantities of opioids… also end(ing) up being cut with other substances.”

Eurich said the machine would provide “good continuity of care” even when patients change doctors, reducing their chances of harm from prescription drugs.

This report by The Canadian Press was first published Feb. 18, 2023

This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship

728x90x4

Source link

Continue Reading

Health

Helping people living with dementia ‘flourish’ through dance

Published

 on

Dr. Pia Kontos, a Senior Scientist at UHN’s KITE Research Institute, is co-leading an initiative to help people living with dementia flourish. (Photo: Tim Fraser/UHN KITE Studio)

Dr. Pia Kontos believes in the power of the arts to support people to live well with dementia.

The Senior Scientist at UHN’s KITE Research Institute focuses on challenging policies and practices that discriminate against those living with dementia and developing and evaluating arts-based and digital knowledge translation initiatives to reduce stigma, improve social inclusion and quality of care for them.

“The predominant assumption is people living with dementia don’t have the capacity to be creative,” says Dr. Kontos, who is also a professor in the Dalla Lana School of Public Health at the University of Toronto. “However, we know through extensive research that dance…powerfully supports people living with dementia to be creative and to flourish.

“And flourishing should be a goal that we all have.”

Dr. Kontos co-produced in 2023 Dancer Not Dementia, a short documentary film. It captured the power of a dance program for seniors – Sharing Dance Older Adults (SDOA) – to challenge the stigma associated with dementia, support social inclusion and enrich lives. It’s told through the eyes of residents and staff at Alexis Lodge Dementia Care Residence and Cedarhurst Dementia Care Home in Toronto.

SDOA was jointly developed by Canada’s National Ballet School (NBS) and Baycrest Centre in 2013 for older adults with a range of physical and cognitive abilities, including dementia.

Typically, dance programs in dementia care settings are provided as a therapeutic intervention for older adults. However, SDOA’s goal is to provide a creative outlet for participants and opportunities for social interaction with other people living with dementia, staff and loved ones.

Now, Dr. Kontos will look to incorporate traditions from marginalized communities into SDOA through a $750,000 Canadian Institutes of Health Research (CIHR) Institute of Aging Implementation Science Team Grant. Dr. Rachel Bar, Director of Research and Health at NBS is co-principal applicant for the grant.

This CIHR funding supports projects that evaluate the effectiveness of existing programs, services and models of care that show promise for those impacted by cognitive impairment and dementia. An important focus is improving equitable and inclusive access to care and support.

The three-year grant to Drs. Kontos and Bar will support SDOA efforts to partner with organizations in Black, Chinese and South Asian communities to integrate their cultural practices into its programming.

Training dancers from these communities to teach the adapted program is central to these partnerships.

“People living with dementia from marginalized communities rarely have their traditions honoured with art and leisure programming,” says Dr. Kontos.

“It’s important to align dance programs with the cultural traditions of these communities. Otherwise, the music and movements wouldn’t reflect the experiences of ethno-culturally diverse populations, and the programs wouldn’t be inclusive.

“We wouldn’t be supporting their capacity to be creative or to be in relationships with others through dance. We would be falling short.”

SDOA has already partnered with Alexis Lodge, Alzheimer Society of Canada, Baycrest, NBS, Indus Community Services, Social Planning Council of Ottawa, and Yee Hong for this initiative.

728x90x4

Source link

Continue Reading

Health

CDC: Heat may have contributed to four human cases of bird flu in Colorado

Published

 on

Credit: Alexas Fotos from Pexels

Heat probably played a role in at least four cases of bird flu in poultry workers confirmed by U.S. health officials Sunday—the first cases in poultry workers in two years.

Sweltering temperatures in Colorado rose to at least 104 degrees, which is suspected to have contributed to the human cases, according to Dr. Nirav Shah, principal deputy director at the Centers for Disease Control and Prevention. The barns where poultry workers were culling chickens were “no doubt even hotter,” Shah said during a press conference on the most recent outbreak of bird flu in humans.

The new cases bring the U.S. total to at least nine cases since the first human case of the current outbreak was detected in 2022, also in a Colorado poultry worker. Eight of the nine were reported this year.

The workers were separating chickens that were going to be killed to stop the spread of the virus. The fans may also have contributed to the human infections because, while helping to keep the environment cooler, they “also spread things like feathers around which are known to carry the virus,” Shah added.

The large and strong fans also make it difficult for protective goggles and face masks to stay in place, he said.

About 60 workers at the poultry farm showed symptoms of illness and were tested for bird flu. Four tested positive for bird flu and one additional presumptive case is awaiting confirmation.

The illnesses were relatively mild, with symptoms including conjunctivitis and common respiratory infection symptoms like fever, chills, coughing, and runny nose, according to the CDC. None were hospitalized, officials said. The other U.S. cases have also been mild.

Officials said they are bracing for more cases.

The CDC says the risk to the general public remains low and the health agency is not recommending livestock workers be vaccinated against bird flu given the “mild symptoms noted thus far,” Shah said.

An initial analysis of virus samples from an infected poultry worker does not show any changes in the virus that would make it easier to spread among people and there is no evidence of person-to-person spread in the U.S.

“It’s important to note that this assessment is based on what we know today and may change,” Shah said. “CDC is constantly looking for key changes that may alter our risk assessment of the virus, such as the severity of illness that it causes, the ease with which it can transmit to humans or changes to its genetic fingerprint.”

At the request of Colorado’s officials, the CDC sent a 10-person team to Colorado to help the state manage the bird flu outbreak in humans and poultry. The team included epidemiologists, veterinarians, clinicians and industrial hygienists.

Shah also noted it was a bilingual team. Overall in the U.S., it is estimated about half of farm workers are Latino.

An analysis of the virus from an infected worker indicates that the infections at the chicken farm are “largely the same” as the strain detected in dairy herds in Colorado and other states, according to Shah. But an investigation is ongoing to determine exactly how the outbreak is spreading between wild birds, chicken and cattle.

Since 2022, a highly contagious strain of bird flu has spread across the U.S. at an unprecedented rate.

Georgia’s powerhouse poultry industry, which produces more broiler chickens than any other in the country, has mostly dodged the kinds of major outbreaks that have resulted in the deaths of more 90 million birds in commercial and backyard poultry flocks in the U.S.

About 1.8 million chickens will be killed at the Colorado poultry farm after these latest bird flu cases were detected.

In late 2023, ducks at a commercial breeding farm in Sumter County, Georgia, tested positive for H5N1. This year, in March, the virus made a jump to a mammal species that surprised many scientists: cows.

With a significant dairy industry, plus even larger beef and poultry interests, the potential arrival of the virus here threatens Georgia’s economy and the health of residents.

As of Monday, the H5N1 virus has been confirmed in 158 dairy herds in 13 states, according U.S. Agriculture Department.

So far in Georgia, there have been no bird flu cases in cattle, and there have been no human cases.

Since the unprecedented spread of H5N1 in poultry in 2022, the Georgia Department of Public Health has quietly monitored 132 people for signs of the virus, according to DPH spokeswoman Nancy Nydam. Those tracked were either first responders to one of the state’s few virus outbreaks in backyard and commercial poultry flocks or farmworkers where the infections occurred. Of those monitored, fewer than 10 people were tested for H5N1 and none came back positive.

Since the virus was discovered in cattle, a small number of first responders from Georgia who went to other states to help with investigations—fewer than 15—have also been monitored for signs of illness.

Federal officials said Tuesday they still believe they can eliminate the bird flu virus from , even as the number of herds infected continues to grow. The latest state to recently report infected dairy cattle was Oklahoma. North Carolina is the only state adjacent to Georgia to report an infected dairy herd.

Eric Deeble, acting senior adviser for the H5N1 response at the USDA, said investigations show the is spreading among cattle through cattle moved from one herd to another and the shared use of milking equipment. It can be contained through enhanced biosecurity measures such as thoroughly cleaning milking “parlors” and equipment, separating sick cows, and having dairy workers wear protective equipment.

Deeble also noted USDA scientists are also working with partners to develop a cattle-specific H5N1 vaccine—a process requires many steps and will take time.

The USDA is also exploring the possibility of developing a poultry vaccine as the number of cases soar, and outbreaks lead to the slaughter of millions of farmed birds. But USDA and industry stakeholders point to challenges that would hinder a vaccination program.

The biggest sticking point is around trade.

Mike Giles, president of the Georgia Poultry Federation, said mass vaccination would be impractical for several reasons, including the fact that the industry would lose its lucrative export market: The United States and many of its trade partners restrict the import of products or eggs from countries affected by the highly pathogenic strain or flocks that have been vaccinated against it.

“(Bird flu) has been, from an animal health standpoint, our top concern,” Giles said. “The challenge, and I think the industry has responded to it well, has been maintaining the state of preparedness and urgency and focus on biosecurity, and I think that has been accomplished.”

2024 The Atlanta Journal-Constitution. Distributed by Tribune Content Agency, LLC.

Citation:
CDC: Heat may have contributed to four human cases of bird flu in Colorado (2024, July 17)
retrieved 17 July 2024
from https://medicalxpress.com/news/2024-07-cdc-contributed-human-cases-bird.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.

 

728x90x4

Source link

Continue Reading

Health

Here is the new guidance for RSV vaccines

Published

 on

Health officials recently changed the guidelines for respiratory syncytial virus vaccines. Here’s what Canadians need to know about the guidance and the virus itself.

New guidance on vaccines

As of July 12, the National Advisory Committee on Immunization (NACI) now recommends RSV vaccines for individuals who are 75 years old and older, especially those who have a greater risk of developing severe RSV.

Based on current evidence and expert opinion, NACI said in a news release, it also strongly recommends vaccines for those aged 60 and older who live in nursing homes and other chronic care facilities.

What is RSV?

RSV is a common contagious virus that often causes bronchiolitis, a lung infection, and pneumonia.

Infants face the highest risk of developing severe RSV disease, however, this risk also increases with age and with certain medical conditions, according to the Public Health Agency of Canada (PHAC). It can lead to serious complications for older people, including hospitalization and death.

What are the symptoms?

RSV typically causes mild, cold-like symptoms that usually begin two to eight days after exposure to the virus, according to PHAC.

Those with RSV may experience a runny nose, coughing, sneezing, wheezing, fever and less appetite and energy. Infants may be irritable, have trouble breathing and have less appetite and energy.

What is the treatment?

RSV infections are usually mild and last about one to two weeks. If you are infected, health officials recommend you stay home and limit contact with others.

They also recommend lots of rest and drinking plenty of fluids. Take over-the-counter products, such as acetaminophen or ibuprofen, if you have a fever. Seek immediate care or go to the hospital if you’re having trouble breathing or become dehydrated, PHAC adds.

Adblock test (Why?)

728x90x4

Source link

Continue Reading

Trending