Dataset Information

Effect of the American Heart Association 2007 Guidelines on the Practice of Dental Prophylaxis for the Prevention of Infective Endocarditis in Olmsted County, Minnesota.

ABSTRACT: To determine the adherence of dental providers to the 2007 American Heart Association (AHA) infective endocarditis prevention guidelines regarding antibiotic drug administration before invasive dental procedures. The study included all adults (≥18 years old) with a moderate-risk (MR) or high-risk (HR) cardiac condition who received dental care at participating dental offices from January 1, 2005, through June 1, 2015, in Olmsted County, Minnesota. Data collected included the date and type of dental procedure performed and receipt of antibiotic prophylaxis (AP). A total of 1351 patients underwent 8854 dental visits at participating dental offices during the study period; 1236 patients had an MR cardiac condition and 115 had an HR condition. The percentage of visits in which antibiotic drugs were used for indicated dental procedures in the MR group declined from 64.6% before to 8.6% after publication of the 2007 AHA guidelines (P<.001); for the HR group, AP declined from 96.9% before to 81.3% after publication of the guidelines (P=.02). In this historical cohort in Olmsted County there was a statistically significant reduction in AP in the MR group before invasive dental procedures. In addition, there was an unanticipated significant reduction in AP in the HR group after publication of the 2007 AHA guidelines. These findings can be used to provide feedback and education to medical and dental professionals who are involved in decision making regarding the use of dental prophylaxis for their patients.

SUBMITTER: DeSimone DC

PROVIDER: S-EPMC5681438 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effect of the American Heart Association 2007 Guidelines on the Practice of Dental Prophylaxis for the Prevention of Infective Endocarditis in Olmsted County, Minnesota.

DeSimone Daniel C DC El Rafei Abdelghani A Challener Douglas W DW Carr Alan B AB Kelly James A JA Rocca Walter A WA St Sauver Jennifer L JL Bock-Goodner Cynthia M CM Lahr Brian D BD Steckelberg James M JM Wilson Walter R WR Baddour Larry M LM

Mayo Clinic proceedings 20170510

<h4>Objective</h4>To determine the adherence of dental providers to the 2007 American Heart Association (AHA) infective endocarditis prevention guidelines regarding antibiotic drug administration before invasive dental procedures.<h4>Patients and methods</h4>The study included all adults (≥18 years old) with a moderate-risk (MR) or high-risk (HR) cardiac condition who received dental care at participating dental offices from January 1, 2005, through June 1, 2015, in Olmsted County, Minnesota. Da ...[more]

PMID: 28549764

Similar Datasets

Project description:ImportanceTrabeculectomy is the surgical standard of care for patients with medically refractory glaucoma. The use of antimetabolite agents, such as mitomycin, has increased the rate of complications after trabeculectomy.ObjectiveTo determine the rate of trabeculectomy-related complications during a 25-year study.Design, setting, and participantsFor this retrospective, population-based study, we enrolled the residents of Olmsted County, Minnesota, who underwent a trabeculectomy from January 1, 1985, through December 31, 2010, at the Mayo Clinic and Olmsted Community Hospital. Data were collected from August 2012 to September 2013 followed by data analysis through January 2014.ExposuresAfter reviewing the patient records, we determined the occurrence of complications, including bleb leak, hypotony, hyphema, choroidal effusion, choroidal hemorrhage, blebitis, and endophthalmitis, as they relate to the mitomycin concentration administered during the operation. We reviewed relevant publications in Ovid, MEDLINE, and PubMed to identify studies representative of the reported trabeculectomy complication rate.Main outcomes and measuresCumulative probabilities of short- and long-term complications, determined using the Kaplan-Meier method, and the relation to mitomycin concentration applied during trabeculectomy.ResultsIn 334 patients, 460 eyes underwent trabeculectomy (mean [SD; range] follow-up, 7.7 [5.7; 0-27.7] years). Among them, 159 eyes had complications, with early complications (<3 months) in 100 eyes and late complications (≥3 months) in 59 eyes during the follow-up. Ten eyes had an early and a late complication. The 20-year cumulative chances of early, late, or any complication were 19.7% (95% CI, 16.2%-23.6%), 26.0% (95% CI, 15.0%-36.0%), and 45.0% (95% CI, 38.0%-52.0%), respectively. The cumulative probabilities of vision-threatening complications during 20 years were 2.0% (95% CI, 0%-4.0%) for blebitis and 5.0% (95% CI, 1.0%-9.0%) for endophthalmitis. Association between the rate of trabeculectomy complications and mitomycin dose used was P = .77. In total, 98 cases (21.3%) underwent further surgical procedures related directly to the complication.Conclusions and relevanceThe rate of trabeculectomy-related complications does not appear to be associated with mitomycin use during a mean follow-up of 7.7 years. The rate of vision-threatening complications appears to be comparable to those of previous studies of shorter duration.

Project description:PurposeInfective endocarditis (IE) is a serious, life-threatening condition requiring antibiotic prophylaxis for high-risk individuals undergoing invasive dental procedures. As LLMs are rapidly adopted by dental professionals for their efficiency and accessibility, assessing their accuracy in answering critical questions about antibiotic prophylaxis for IE prevention is crucial.MethodsTwenty-eight true/false questions based on the 2021 American Heart Association (AHA) guidelines for IE were posed to 7 popular LLMs. Each model underwent five independent runs per question using two prompt strategies: a pre-prompt as an experienced dentist and without a pre-prompt. Inter-model comparisons utilised the Kruskal-Wallis test, followed by post-hoc pairwise comparisons using Prism 10 software.ResultsSignificant differences in accuracy were observed among the LLMs. All LLMs had a narrower confidence interval with a pre-prompt, and most, except Claude 3 Opus, showed improved performance. GPT-4o had the highest accuracy (80% with a pre-prompt, 78.57% without), followed by Gemini 1.5 Pro (78.57% and 77.86%) and Claude 3 Opus (75.71% and 77.14%). Gemini 1.5 Flash had the lowest accuracy (68.57% and 63.57%). Without a pre-prompt, Gemini 1.5 Flash's accuracy was significantly lower than Claude 3 Opus, Gemini 1.5 Pro, and GPT-4o. With a pre-prompt, Gemini 1.5 Flash and Claude 3.5 were significantly less accurate than Gemini 1.5 Pro and GPT-4o. None of the LLMs met the commonly used benchmark scores. All models provided both correct and incorrect answers randomly, except Claude 3.5 Sonnet with a pre-prompt, which consistently gave incorrect answers to eight questions across five runs.ConclusionLLMs like GPT-4o show promise for retrieving AHA-IE guideline information, achieving up to 80% accuracy. However, complex medical questions may still pose a challenge. Pre-prompts offer a potential solution, and domain-specific training is essential for optimizing LLM performance in healthcare, especially with the emergence of models with increased token limits.

Project description:ObjectiveTo determine the longitudinal trends in the probability of blindness due to open-angle glaucoma (OAG) in Olmsted County, Minnesota, from 1965 to 2009.DesignRetrospective, population-based cohort study.ParticipantsAll residents of Olmsted County, Minnesota (aged ≥ 40 years) who were diagnosed with OAG between January 1, 1965, and December 31, 2000.MethodsAll available medical records of every incident case of OAG were reviewed until December 31, 2009, to identify progression to blindness, defined as visual acuity ≤ 20/200 or visual field constriction to ≤ 20°. Kaplan-Meier analysis was used to estimate the cumulative probability of glaucoma-related blindness. Population incidence of blindness within 10 years of diagnosis was calculated using US Census data. Rates for subjects diagnosed in the period 1965-1980 were compared with rates for subjects diagnosed in the period 1981-2000 using log-rank tests and Poisson regression models.Main outcome measuresCumulative probability of OAG-related blindness and population incidence of blindness within 10 years of diagnosis.ResultsProbability of glaucoma-related blindness in at least 1 eye at 20 years decreased from 25.8% (95% confidence interval [CI], 18.5-32.5) for subjects diagnosed in 1965-1980 to 13.5% (95% CI, 8.8-17.9) for subjects diagnosed in 1981-2000 (P = 0.01). The population incidence of blindness within 10 years of the diagnosis decreased from 8.7 per 100,000 (95% CI, 5.9-11.5) for subjects diagnosed in 1965-1980 to 5.5 per 100,000 (95% CI, 3.9-7.2) for subjects diagnosed in 1981-2000 (P = 0.02). Higher age at diagnosis was associated with increased risk of progression to blindness (P < 0.001).ConclusionsThe 20-year probability and the population incidence of blindness due to OAG in at least 1 eye have decreased over a 45-year period from 1965 to 2009. However, a significant proportion of patients still progress to blindness despite recent diagnostic and therapeutic advancements.

Dataset Information

Effect of the American Heart Association 2007 Guidelines on the Practice of Dental Prophylaxis for the Prevention of Infective Endocarditis in Olmsted County, Minnesota.

Publications

Effect of the American Heart Association 2007 Guidelines on the Practice of Dental Prophylaxis for the Prevention of Infective Endocarditis in Olmsted County, Minnesota.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets