BackgroundWomen continue to have worse Coronary Artery Disease (CAD) outcomes than men. The causes of this discrepancy have yet to be fully elucidated. The main objective of this study is to detect gender discrepancies in the diagnosis and treatment of CAD.MethodsWe used data analytics to risk stratify ~32,000 patients with CAD of the total 960,129 patients treated at the UCSF Medical Center over an 8 year period. We implemented a multidimensional data analytics framework to trace patients from admission through treatment to create a path of events. Events are any medications or noninvasive and invasive procedures. The time between events for a similar set of paths was calculated. Then, the average waiting time for each step of the treatment was calculated. Finally, we applied statistical analysis to determine differences in time between diagnosis and treatment steps for men and women.ResultsThere is a significant time difference from the first time of admission to diagnostic Cardiac Catheterization between genders (p-value = 0.000119), while the time difference from diagnostic Cardiac Catheterization to CABG is not statistically significant.ConclusionWomen had a significantly longer interval between their first physician encounter indicative of CAD and their first diagnostic cardiac catheterization compared to men. Avoiding this delay in diagnosis may provide more timely treatment and a better outcome for patients at risk. Finally, we conclude by discussing the impact of the study on improving patient care with early detection and managing individual patients at risk of rapid progression of CAD.
The development of an ontology facilitates the organization of the variety of concepts used to describe different terms in different resources. The proposed ontology will facilitate the study of cardiothoracic surgical education and data analytics in electronic medical records (EMR) with the standard vocabulary.
In a study conducted by Kwok Leung Ong et al. [6], they suggested that sex hormones could be responsible for gender differences in coordination with blood pressure. Even though there
Background: Cardiovascular Disease (CVD) and Coronary Artery Disease (CAD) in particular, is one of the leading causes of death, morbidity, and mortality in the United States. Notably, women continue to have worse outcomes than men. The causes of these discrepancies have yet to be fully elucidated. The main objective of this study is to detect gender discrepancies in outcome using data analytics to risk stratify ~ 32,000 patients with CAD of the total 960,129 patients treated at UCSF Medical Center during an eight years. As an implementation of clinical care, this study’s long-term goal is to improve precision diagnosis and ultimately management of CAD for both early detection and identification of patients at risk for rapid progression of the disease.Methods: We designed and implemented a multidimensional framework to trace patients from admission through treatment as a path of events. The time between events for a similar set of paths was calculated. Then the average waiting time for each step of the treatment was calculated for men and women. Finally, we applied statistical analysis to determine differences in time between diagnosis and treatment steps for men and women.Discussions: There were statistically significant gender-based differences in the common path of diagnosis and treatment of patients with CAD. The average time for women from the first visit to diagnostic Cardiac Catheterization was more than 2 months than for men (358.77 vs. 291.83 days). By contrast, the average time from diagnostic Cardiac Catheterization to treatment Cardiac Catheterization and Coronary Artery Bypass Grafting (CABG) was not significant. Women with CAD requiring revascularization have a significantly longer interval between their first physician encounter indicative of CVD and their first diagnostic cardiac catheterization compared to men. Avoiding the delay in diagnosis and treatment will provide a better outcome for patients at risk.
Early detection plays a key role to enhance the outcome for Coronary Artery Disease. We utilized a big data analytics platform on ∼32,000 patients to trace patients from the first encounter to CAD treatment. There are significant gender-based differences in patients younger than 60 from the time of the first encounter to Coronary Artery Bypass Grafting with a p-value=0.03. This recognition makes significant changes in outcome by avoiding delay in treatment.
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