This document summarizes a clinical trial comparing sacubitril-valsartan to ramipril in patients with a myocardial infarction (MI) and reduced left ventricular ejection fraction (LVEF) less than 40% or pulmonary congestion. The primary outcome was a composite of death or first incident of heart failure. While sacubitril-valsartan did not significantly reduce the primary outcome compared to ramipril, pre-specified analyses found reductions in both investigator-reported and adjudicated events, supporting incremental clinical benefits. Safety and tolerability were comparable between the two treatments. The study had strengths of being a large randomized controlled trial with similar baseline characteristics between groups, but lacked representation from Africa and fewer female participants
The title of the talk is emblematic of the binary way that we have approached structural heart disease where cardiac surgery or an interventional procedure might be required – this thinking is now transitioning to an entirely different paradigm which is that of the “Heart Team”.
Remarkable advances over the last decade have led to a plethora of interventional options for both coronary and structural heart disease. In the coronary realm, as complex and high risk PCI options continue to evolve, the role for surgery in multi-vessel disease, diabetes and LV dysfunction has become well established. Hybrid revascularization options also evolve and are the subject of ongoing investigation. In structural heart disease, as TAVR application expands to a low risk subset, ongoing investigations will answer questions regarding durability of TAVR as compared to the historical surgical gold standard. Mitral valve repair remains the gold standard for degenerative MR and the Mitraclip has become a well-established option for a high-risk subset. Ongoing studies will answer the role of Mitraclip in functional MR and excitingly multicenter studies are investigating a role for transcatheter mitral valve replacement for mitral valve disease. The role of surgery in tricuspid valve disease, a large and underserved subset remains controversial and transcatheter devices remain investigational at this point. The reality is that decision-making is complex and central to the entire debate is the heart team concept, whereby surgeons and interventionalists sit at the same table as part of the same team to determine the best approach for any given patient. As evidence continues to evolve, lines between cardiac surgery and interventional cardiology continue to blur, with combined expertise from both sides going forward required to best serve our patients in a truly heart team approach.
Data Driven is just the beginning, why the details of evidence matter by Dr. ...James McCarter
At Virta Health, our values include being evidence-based and prioritizing data and science over opinion in our decision-making. But how does this apply to the data we provide employers? Here are three questions we think employers should be asking healthcare providers and vendors offering health solutions to make smarter data-driven decisions (and some examples of vendor data that doesn’t stand up to scrutiny).
SVMPharma Real World Evidence - Randomised controlled trials were never desig...SVMPharma Limited
SVMPharma Real World Evidence - Conventional RCTs are necessary for determining efficacy and safety, but real-world clinical practice can be very different. RWE complements RCT data and offers the opportunity to bridge the data gaps.
Have you identified your data gaps? For more information and resources visit us at www.svmpharma.com
Introducing VSClinical AMP Guidelines: A Comprehensive Workflow for NGS Testi...Golden Helix
The individualized nature of tumors requires genomic testing for providing the best outcomes for patients. Next-Generation Sequencing enables the detection of small mutations, copy number changes, and common fusions affordably and with high precision. However, the interpretation of these detected variants is arduous without a comprehensive analytical workflow that can incorporate all the bioinformatics and clinical evidence involved in following the AMP guidelines for the scoring and reporting of somatic mutations.
Please join us as we reveal the AMP guidelines workflow support in VSClinical. We will cover the entire post-sequencing analytical workflow from FASTQ to clinical report, including:
- Apply the AMP Tiers to the available clinical evidence for Drug Sensitivity, Drug Response, Prognostics and Diagnostics
Support small mutations (SNPs, InDels) along with CNVs, fusions and wild-types as relevant biomarkers for the reporting of clinical evidence
- Develop a lab-specific knowledgebase of interpretations that allow maximum re-use of interpretations and descriptions from one patient to the next
- Leverage the built-in Golden Helix CancerKB interpretation knowledgebase that covers many common genes and biomarkers
- When detecting inherited and not somatic variants in a patient, score and classify them using the ACMG guidelines and report as secondary germline findings
- Use the Oncogenicity scoring system for evaluating the impact of variants in cancer
- Customize your clinical report using Word to reflect your lab's preferences and branding
- Building on the success of VSClinical’s ACMG guidelines, the new VSClinical AMP guidelines enables new and existing labs to provide genetic tests for cancer efficiently and with a focus on delivering consistent and accurate results.
The title of the talk is emblematic of the binary way that we have approached structural heart disease where cardiac surgery or an interventional procedure might be required – this thinking is now transitioning to an entirely different paradigm which is that of the “Heart Team”.
Remarkable advances over the last decade have led to a plethora of interventional options for both coronary and structural heart disease. In the coronary realm, as complex and high risk PCI options continue to evolve, the role for surgery in multi-vessel disease, diabetes and LV dysfunction has become well established. Hybrid revascularization options also evolve and are the subject of ongoing investigation. In structural heart disease, as TAVR application expands to a low risk subset, ongoing investigations will answer questions regarding durability of TAVR as compared to the historical surgical gold standard. Mitral valve repair remains the gold standard for degenerative MR and the Mitraclip has become a well-established option for a high-risk subset. Ongoing studies will answer the role of Mitraclip in functional MR and excitingly multicenter studies are investigating a role for transcatheter mitral valve replacement for mitral valve disease. The role of surgery in tricuspid valve disease, a large and underserved subset remains controversial and transcatheter devices remain investigational at this point. The reality is that decision-making is complex and central to the entire debate is the heart team concept, whereby surgeons and interventionalists sit at the same table as part of the same team to determine the best approach for any given patient. As evidence continues to evolve, lines between cardiac surgery and interventional cardiology continue to blur, with combined expertise from both sides going forward required to best serve our patients in a truly heart team approach.
Data Driven is just the beginning, why the details of evidence matter by Dr. ...James McCarter
At Virta Health, our values include being evidence-based and prioritizing data and science over opinion in our decision-making. But how does this apply to the data we provide employers? Here are three questions we think employers should be asking healthcare providers and vendors offering health solutions to make smarter data-driven decisions (and some examples of vendor data that doesn’t stand up to scrutiny).
SVMPharma Real World Evidence - Randomised controlled trials were never desig...SVMPharma Limited
SVMPharma Real World Evidence - Conventional RCTs are necessary for determining efficacy and safety, but real-world clinical practice can be very different. RWE complements RCT data and offers the opportunity to bridge the data gaps.
Have you identified your data gaps? For more information and resources visit us at www.svmpharma.com
Introducing VSClinical AMP Guidelines: A Comprehensive Workflow for NGS Testi...Golden Helix
The individualized nature of tumors requires genomic testing for providing the best outcomes for patients. Next-Generation Sequencing enables the detection of small mutations, copy number changes, and common fusions affordably and with high precision. However, the interpretation of these detected variants is arduous without a comprehensive analytical workflow that can incorporate all the bioinformatics and clinical evidence involved in following the AMP guidelines for the scoring and reporting of somatic mutations.
Please join us as we reveal the AMP guidelines workflow support in VSClinical. We will cover the entire post-sequencing analytical workflow from FASTQ to clinical report, including:
- Apply the AMP Tiers to the available clinical evidence for Drug Sensitivity, Drug Response, Prognostics and Diagnostics
Support small mutations (SNPs, InDels) along with CNVs, fusions and wild-types as relevant biomarkers for the reporting of clinical evidence
- Develop a lab-specific knowledgebase of interpretations that allow maximum re-use of interpretations and descriptions from one patient to the next
- Leverage the built-in Golden Helix CancerKB interpretation knowledgebase that covers many common genes and biomarkers
- When detecting inherited and not somatic variants in a patient, score and classify them using the ACMG guidelines and report as secondary germline findings
- Use the Oncogenicity scoring system for evaluating the impact of variants in cancer
- Customize your clinical report using Word to reflect your lab's preferences and branding
- Building on the success of VSClinical’s ACMG guidelines, the new VSClinical AMP guidelines enables new and existing labs to provide genetic tests for cancer efficiently and with a focus on delivering consistent and accurate results.
Introducing Drugs & Trials for Cancer DiagnosticsGolden Helix
When interpreting a variant using the AMP/ASCO guidelines for somatic variant interpretation, clinicians must determine whether the variant can be considered a biomarker that affects clinical care by predicting sensitivity, resistance, or toxicity to a specific therapy. Such a determination requires the investigation of multiple evidence sources, including clinical trials, FDA approved therapies and peer-reviewed studies. Unfortunately, strong evidence linking specific genetic biomarkers to FDA-approved therapies only exists for a small number of cancers. Thus, most variants require an exploration of clinical practice guidelines, peer-reviewed literature, and large-scale cancer mutation databases to effectively assess the clinical significance of a given mutation.
This webcast explores this new incorporation of Drugs & Trials Annotations in VSClinical's AMP Workflow covering:
Identification of relevant clinical evidence for drug sensitivity and resistance based on patient biomarkers and tumor type
Review of clinical trial information including inclusion criteria, trial status, and contact information
Management of citations associated with relevant, targeted therapies
Evaluation of a biomarkers clinical evidence tier based on available evidence for drug sensitivity and resistance
Introducing Drugs & Trials for Cancer DiagnosticsGolden Helix
When interpreting a variant using the AMP/ASCO guidelines for somatic variant interpretation, clinicians must determine whether the variant can be considered a biomarker that affects clinical care by predicting sensitivity, resistance, or toxicity to a specific therapy. Such a determination requires the investigation of multiple evidence sources, including clinical trials, FDA approved therapies and peer-reviewed studies. Unfortunately, strong evidence linking specific genetic biomarkers to FDA-approved therapies only exists for a small number of cancers. Thus, most variants require an exploration of clinical practice guidelines, peer-reviewed literature, and large-scale cancer mutation databases to effectively assess the clinical significance of a given mutation.
This webcast explores this new incorporation of Drugs & Trials Annotations in VSClinical's AMP Workflow covering:
Identification of relevant clinical evidence for drug sensitivity and resistance based on patient biomarkers and tumor type
Review of clinical trial information including inclusion criteria, trial status, and contact information
Management of citations associated with relevant, targeted therapies
Evaluation of a biomarkers clinical evidence tier based on available evidence for drug sensitivity and resistance
The Design of Accountable Care OrganizationsCJ Fulton
Pillars for Accountable Care
PCMH versus ACOs
Core competencies
Six core structural components of successful ACO deployment
Pioneer ACO burn and learn lessons
Barriers & root cause analysis
Patient attribution
Five modes of Accountable Care
Early value-based adopters
Value discovery assessment
Modified Triple Aim
GPRO
Breakdown by 33 Measures
Introducing Drugs & Trials for Cancer DiagnosticsGolden Helix
When interpreting a variant using the AMP/ASCO guidelines for somatic variant interpretation, clinicians must determine whether the variant can be considered a biomarker that affects clinical care by predicting sensitivity, resistance, or toxicity to a specific therapy. Such a determination requires the investigation of multiple evidence sources, including clinical trials, FDA approved therapies and peer-reviewed studies. Unfortunately, strong evidence linking specific genetic biomarkers to FDA-approved therapies only exists for a small number of cancers. Thus, most variants require an exploration of clinical practice guidelines, peer-reviewed literature, and large-scale cancer mutation databases to effectively assess the clinical significance of a given mutation.
This webcast explores this new incorporation of Drugs & Trials Annotations in VSClinical's AMP Workflow covering:
Identification of relevant clinical evidence for drug sensitivity and resistance based on patient biomarkers and tumor type
Review of clinical trial information including inclusion criteria, trial status, and contact information
Management of citations associated with relevant, targeted therapies
Evaluation of a biomarkers clinical evidence tier based on available evidence for drug sensitivity and resistance
Introducing Drugs & Trials for Cancer DiagnosticsGolden Helix
When interpreting a variant using the AMP/ASCO guidelines for somatic variant interpretation, clinicians must determine whether the variant can be considered a biomarker that affects clinical care by predicting sensitivity, resistance, or toxicity to a specific therapy. Such a determination requires the investigation of multiple evidence sources, including clinical trials, FDA approved therapies and peer-reviewed studies. Unfortunately, strong evidence linking specific genetic biomarkers to FDA-approved therapies only exists for a small number of cancers. Thus, most variants require an exploration of clinical practice guidelines, peer-reviewed literature, and large-scale cancer mutation databases to effectively assess the clinical significance of a given mutation.
This webcast explores this new incorporation of Drugs & Trials Annotations in VSClinical's AMP Workflow covering:
Identification of relevant clinical evidence for drug sensitivity and resistance based on patient biomarkers and tumor type
Review of clinical trial information including inclusion criteria, trial status, and contact information
Management of citations associated with relevant, targeted therapies
Evaluation of a biomarkers clinical evidence tier based on available evidence for drug sensitivity and resistance
The Design of Accountable Care OrganizationsCJ Fulton
Pillars for Accountable Care
PCMH versus ACOs
Core competencies
Six core structural components of successful ACO deployment
Pioneer ACO burn and learn lessons
Barriers & root cause analysis
Patient attribution
Five modes of Accountable Care
Early value-based adopters
Value discovery assessment
Modified Triple Aim
GPRO
Breakdown by 33 Measures
Chatty Kathy - UNC Bootcamp Final Project Presentation - Final Version - 5.23...John Andrews
SlideShare Description for "Chatty Kathy - UNC Bootcamp Final Project Presentation"
Title: Chatty Kathy: Enhancing Physical Activity Among Older Adults
Description:
Discover how Chatty Kathy, an innovative project developed at the UNC Bootcamp, aims to tackle the challenge of low physical activity among older adults. Our AI-driven solution uses peer interaction to boost and sustain exercise levels, significantly improving health outcomes. This presentation covers our problem statement, the rationale behind Chatty Kathy, synthetic data and persona creation, model performance metrics, a visual demonstration of the project, and potential future developments. Join us for an insightful Q&A session to explore the potential of this groundbreaking project.
Project Team: Jay Requarth, Jana Avery, John Andrews, Dr. Dick Davis II, Nee Buntoum, Nam Yeongjin & Mat Nicholas
As Europe's leading economic powerhouse and the fourth-largest hashtag#economy globally, Germany stands at the forefront of innovation and industrial might. Renowned for its precision engineering and high-tech sectors, Germany's economic structure is heavily supported by a robust service industry, accounting for approximately 68% of its GDP. This economic clout and strategic geopolitical stance position Germany as a focal point in the global cyber threat landscape.
In the face of escalating global tensions, particularly those emanating from geopolitical disputes with nations like hashtag#Russia and hashtag#China, hashtag#Germany has witnessed a significant uptick in targeted cyber operations. Our analysis indicates a marked increase in hashtag#cyberattack sophistication aimed at critical infrastructure and key industrial sectors. These attacks range from ransomware campaigns to hashtag#AdvancedPersistentThreats (hashtag#APTs), threatening national security and business integrity.
🔑 Key findings include:
🔍 Increased frequency and complexity of cyber threats.
🔍 Escalation of state-sponsored and criminally motivated cyber operations.
🔍 Active dark web exchanges of malicious tools and tactics.
Our comprehensive report delves into these challenges, using a blend of open-source and proprietary data collection techniques. By monitoring activity on critical networks and analyzing attack patterns, our team provides a detailed overview of the threats facing German entities.
This report aims to equip stakeholders across public and private sectors with the knowledge to enhance their defensive strategies, reduce exposure to cyber risks, and reinforce Germany's resilience against cyber threats.
Adjusting primitives for graph : SHORT REPORT / NOTESSubhajit Sahu
Graph algorithms, like PageRank Compressed Sparse Row (CSR) is an adjacency-list based graph representation that is
Multiply with different modes (map)
1. Performance of sequential execution based vs OpenMP based vector multiply.
2. Comparing various launch configs for CUDA based vector multiply.
Sum with different storage types (reduce)
1. Performance of vector element sum using float vs bfloat16 as the storage type.
Sum with different modes (reduce)
1. Performance of sequential execution based vs OpenMP based vector element sum.
2. Performance of memcpy vs in-place based CUDA based vector element sum.
3. Comparing various launch configs for CUDA based vector element sum (memcpy).
4. Comparing various launch configs for CUDA based vector element sum (in-place).
Sum with in-place strategies of CUDA mode (reduce)
1. Comparing various launch configs for CUDA based vector element sum (in-place).
5. Hypothesis and Clinical question
Hypothesis
Among patients with MI, complicated by reduced LVEF less
than 40%, pulmonary congestion or both…?
Clinical question
Can sacubitril-valsartan compared to Ramipril reduce the
composite end point of death or first incident of heart failure.
17. During trial visit
Patients Were Evaluated Periodically At Trial Visits For and hospital
stay
Weight change
Health Status
Adverse Events.
MACE
Vital Signs,
Glycated Hemoglobin Level,
eGFR,
Quality of life
23. summary
In a vigorously managed enhanced risk AMI population
compared to active therapy with ramipril:
• Sacubitril/valsartan did not result in a significantly lower
rate of CV death, heart failure hospitalization or outpatient
heart failure requiring treatment.
• Pre-specified observations of reductions in both the
investigator reports of the primary composite as well as in
the total (recurrent) adjudicated events support incremental
clinical benefits of sacubitril/valsartan.
• The safety and tolerability of sacubitril/valsartan in this AMI
population was comparable to that of the ACEi.
24. Critical appraisal
⚫Strengths
Study design was CRT
Sample size
Appropriate statistical analysis
Baseline characteristics are similar among all patients. with OGDMT
Similar use of medications to manage other health conditions
25. Weakness
• No Africa representation
• Less female participation
• Did not reached the primary outcome
Critical appraisal
