ORCID Profile
0000-0001-8390-1741
Current Organisation
Monash University
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2019
DOI: 10.1161/STROKEAHA.119.025838
Abstract: Rapid reperfusion with mechanical thrombectomy in ischemic strokes with emergent large vessel occlusions leads to significant reduction in morbidity and mortality. The door-in-door-out (DIDO) time is an important metric for stroke centers without an on-site mechanical thrombectomy service. We report the outcome of a continuous quality improvement program to improve the DIDO time since 2015. Retrospective analysis of consecutive patients transferred out from a metropolitan primary stroke center for consideration of mechanical thrombectomy between January 1, 2015, and October 31, 2018. Clinical records were interrogated for eligible patients with DIDO times and reasons for treatment delays extracted. One hundred thirty-three patients were transferred over the 46-month period. Median DIDO time reduced by 14% per year, from 111 minutes interquartile range (IQR, 98– 142) in 2015 to 67 minutes (IQR, 55–94) in 2018. A median DIDO time of 59 minutes (IQR, 51–80) was achieved in 2018 during working hours (0800–1700 hours). Overall, 65 patients had no documented delays (49%) with a median DIDO time of 75 minutes (IQR, 54–93) and 103 minutes (IQR, 75–143) in those with at least one delay factor documented. A median DIDO time of minutes can be achieved in a primary stroke center.
Publisher: Elsevier BV
Date: 12-2017
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJOPEN-2022-065568
Abstract: To determine the negative predictive value (NPV) of the FebriDx point-of-care host response device in patients presenting with symptoms suggestive of COVID-19 infection in a mostly immunised Australian emergency department (ED) population during the late 2021 phase of the COVID-19 pandemic. Observational diagnostic accuracy study comparing FebriDx point-of-care test to SARS-CoV-2 PCR. An ED in Melbourne, Australia, with 63 000 annual presentations in 2021. Patients aged 16 and over who met the Victorian Department of Health case definition for suspected COVID-19 infection PCR testing. Patients meeting any of the following criteria were excluded: years of age acute respiratory symptom(s) with onset days prior to testing current immunosuppressive or interferon therapy live immunisation within the last 30 days fever lasting days antibiotic or antiviral use in the preceding 14 days experience of major trauma, major surgical intervention or severe burns within the last 30 days. COVID-19 PCR results (detected, not detected) and FebriDx results (bacterial positive, viral negative, viral positive). 94 participants were enrolled (female: 46 male: 48), 34% of participants (tested positive for COVID-19 according to PCR results, with a background incidence among all adult ED attenders of 2.5%. The sensitivity of FebriDx for detection of COVID-19 was 56% (95% CI 40% to 100%) and specificity was 92% (95% CI 84% to 100%). For the population tested, this resulted in an NPV of 80% (95% CI 71% to 100%) and a positive predictive value of 78% (95% CI 60% to 100%). In the context of a population with low COVID-19 infection rates, an evolved variant of COVID-19 and a very high community COVID-19 vaccination rate, FebriDx demonstrated reduced sensitivity and NPV relative to results from earlier international tests. These contextual factors should be considered during any attempt to generalise the current results. ACTRN12620001029987 (Australian Clinical Trials).
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Oxford University Press (OUP)
Date: 1999
Abstract: Exponential smoothing is the most common model-free means of forecasting a future realization of a time series. It requires the specification of a smoothing factor which is usually chosen from the data to minimize the average squared residual of previous one-step-ahead forecasts. In this paper we show that exponential smoothing can be put into a nonparametric regression framework and gain some interesting insights into its performance through this interpretation. We also use theoretical developments from the kernel regression field to derive, for the first time, asymptotic properties of exponential smoothing forecasters.
Publisher: SAGE Publications
Date: 03-12-2017
Abstract: Evidence on the medium-term clinical course of recurrent headaches is scarce. This study explored the six-month course and factors associated with non-improvement in migraine compared with tension-type headache and cervicogenic headache. In this longitudinal cohort study, the six-month course of headaches was prospectively examined in participants (n = 37 with migraine n = 42 with tension-type or cervicogenic headache). Participants underwent physical examination for cervical musculoskeletal impairments at baseline. Participants also completed questionnaires on pain, disability and other self-report measures at baseline and follow-up, and kept an electronic diary for 6 months. Course of headaches was examined using mixed within-between analyses of variance and Markov chain modeling. Multiple factors were evaluated as possible factors associated with non-improvement using regression analysis. Headache frequency, intensity, and activity interference in migraine and non-migraine headaches were generally stable over 6 months but showed month-to-month variations. Day-to-day variations were more volatile in the migraine than the non-migraine group, with the highest probability of transitioning from any headache state to no headache (probability = 0.82–0.85). The odds of non-improvement in disability was nearly six times higher with cervical joint dysfunction (odds ratio [95% CI] = 5.58 [1.14–27.42]). Headache frequency, intensity, and activity interference change over 6 months, with day-to-day variation being more volatile in migraine than non-migraine headaches. Cervical joint dysfunction appears to be associated with non-improvement for disability in 6 months. These results may contribute to strategies for educating patients to help align their expectations with the nature of their headaches.
No related grants have been discovered for Deeksha Bhardwaj.