Internal medicine journal
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Internal medicine journal · Jul 2024
Improving the performance of machine learning penicillin adverse drug reaction classification with synthetic data and transfer learning.
Machine learning may assist with the identification of potentially inappropriate penicillin allergy labels. Strategies to improve the performance of existing models for this task include the use of additional training data, synthetic data and transfer learning. ⋯ Machine learning models demonstrate high levels of accuracy in the classification and risk stratification of penicillin ADR labels using the reaction documented in the EHR. The model can be further optimised by incorporating additional training data and using transfer learning. Practical applications include automating case detection for penicillin allergy delabelling programmes.
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Internal medicine journal · Jul 2024
Heart failure and the cost of dying: must the ferryman always be paid?
Provision of palliative care in chronic heart failure (CHF) can support complex decision-making, significantly improve quality of life and may lower healthcare costs. ⋯ A palliative approach in terminal CHF admission may improve quality at the end of life and decrease costs associated with care.
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Internal medicine journal · Jul 2024
ReviewDemystifying normal-anion-gap metabolic acidosis: pathophysiology, aetiology, evaluation and diagnosis.
Normal-anion-gap metabolic acidosis (NAGMA) is a common but often under-recognised and poorly understood condition, especially by less-experienced clinicians. In adults, NAGMA might be an initial clue to a more significant underlying pathology, such as autoimmune diseases, hypergammaglobulinemia or drug toxicities. ⋯ A better understanding of the pathophysiology of NAGMA can help treating physicians suspect and evaluate the condition early and reach the correct diagnosis. This article provides an overview of renal acid-base regulation, discusses the pathophysiological processes involved in developing NAGMA and provides a framework for evaluation to reach an accurate diagnosis.
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Internal medicine journal · Jul 2024
The cascade of care for hepatitis C in Victoria, Australia: a data linkage cohort study.
Highly effective hepatitis C therapies are available in Australia. However, people living with hepatitis C face various barriers to accessing care and treatment. ⋯ Despite an enabling policy environment and subsidised therapy, many people in this cohort were not treated. Increased measures may be needed to engage people in care, including those who acquired hepatitis C more than 10 years ago.