Archives     Advertise     Editorial Calendar      Advertiser Index     Subscribe     Contact Us    

Predicting Blood Clots Before They Happen in Pediatric Patients

Shannon Walker, MD

Monroe Carell Jr. Children's Hospital at Vanderbilt has launched a study to determine the impact of a predictive model for identifying pediatric patients at risk for developing blood clots or venous thromboembolisms (VTEs).

The study uses advanced predictive analytics to inform medical teams of patients at risk for blood clots before they happen.

"Hospital-associated blood clots are an increasing cause of morbidity in pediatrics," said the study's principal investigator, Shannon Walker, MD, clinical fellow of Pediatric Hematology-Oncology at Children's Hospital.

While these events are more rare among children than they are among adults, Walker noticed that blood clot development was on the rise.

"The reason children get blood clots is very different from adults," said Walker, who worked with mentors Allison Wheeler, MD, MSCI, assistant professor of Pediatrics and Pathology, Microbiology and Immunology, and C. Buddy Creech, MD, MPH, director of the Vanderbilt Vaccine Research Program and associate professor of Pediatric Infectious Diseases.

"There was no standardized protocol for preventing clots in pediatric patients. As we noticed that the rate of blood clots was going up and recognized that the adult strategy wasn't going to work for our patients, we wanted to look at each patient's individual risk factors and see how we could focus our attention on targeted blood clot prevention."

The study, set to be published in Pediatrics, describes how the team built and validated a predictive model that can be automated to run within the electronic health record of each patient admitted to the hospital.

The model includes 11 risk factors and was based on an analysis of more than 110,000 admissions to Children's Hospital and has been validated on more than 44,000 separate admissions.

Currently the team is studying using this model along with targeted intervention in the clinical setting in a trial called "Children's Likelihood of Thrombosis," or CLOT.

The prediction model is used in this way: every child admitted to the hospital has a risk score calculated. The patients are randomized, so in half of the patients, elevated scores are reviewed by a hematologist, and then discussed with each patient's medical team and family to determine a personalized prevention plan. All patients, regardless of randomization, continue to receive the current standard of care.

"We are not utilizing a one-size-fits-all plan," Walker said. "This is an extra level of review allowing for a very personalized recommendation for each patient with an elevated score. Each day the score is updated, so as risk factors change, the scores change accordingly.

"We are, in real-time, assessing the use of this model as a clinical support tool. We saw a clinical opportunity of something we could improve and have moved forward with building the model -- to identify high-risk patients and are currently performing the CLOT trial, which will run through the end of the year."

Walker's study was possible with the help of the Advanced Vanderbilt Artificial Intelligence Laboratory, or AVAIL. Only in its second year, the program is leading the way supporting artificial intelligence tools at VUMC through project incubation and curation, including facilitating clinical trials to assess their effectiveness.

"AVAIL served as a catalyst, in this instance by bringing experts in a complex trial development into proximity so that a great synthesis could happen," said Warren Sandberg, MD, PhD, executive sponsor of AVAIL, along with Kevin Johnson, MD.

"What is unique about this particular project is that we were not only able to predict complications but also able to test the model in a rigorous, pragmatic, randomized, controlled trial to see if it benefits patients," said Dan Byrne, senior biostatistician for the project and director of artificial intelligence research for AVAIL.

"The future of this kind of work is unlimited," he said. "We can hopefully use this approach to predict and prevent pressure injuries, sepsis, falls, readmissions or most any complication before they happen. At Vanderbilt, we are raising the bar when it comes to the science of personalized medicine and application of artificial intelligence in medicine in a way that is both ethical and safe."

Authors of the paper include Walker, Wheeler, Creech, Byrne, Henry Domenico, MS, and Benjamin French, PhD. Ryan Moore, MS, is the biostatistician for the CLOT trial.


Related Articles:

Recent Articles

Meharry Medical College and University of Memphis Launch PECIR Program, Driving Research Collaborations

Read More

UPDATE: UnitedHealthcare Policy on Emergency Coverage

Read More

ACEP Condemns UnitedHealthcare's New Policy to Retroactively Deny Emergency Care

The American College of Emergency Physicians (ACEP) strongly condemns the dangerous decision by UnitedHealthcare to retroactively deny emergency care claims.

Read More

Gerald E. Harmon, M.D., Inaugurated as 176th president of the AMA

Gerald E. Harmon, M.D., a family medicine physician from Pawleys Island, S.C., will be sworn in today as the 176th president of the American Medical Association (AMA), the nation's premier physician organization.

Read More

American Telemedicine Association: Policy Halftime Report As State Legislators Head Into Summer Recess

As most state legislators head into summer recess, the American Telemedicine Association (ATA) reflects on a very active first half of the year, which saw all 50 state legislatures introducing new or updated telehealth bills.

Read More

NIH-funded study tests "one-stop" mobile clinics to deliver HIV, substance use care

One of five mobile health clinics deployed for the NIH-funded INTEGRA study. Artwork for the clinic was designed by artist Shepard Fairey.

Read More

COVID-19 Pandemic Brought Changes in Cigarette Smoking: Study

Smokers who believed they were at increased risk of getting COVID-19 during the pandemic, or having a more severe case, were more likely to quit while those who perceived more stress increased smoking, according to new research published in the Journal of General Internal Medicine.

Read More

Secret Shopper Study Sheds Light on Barriers to Opioid Treatment for Women

After a 2020 Vanderbilt University Medical Center study showed women have a difficult time accessing treatment for opioid use disorder (OUD), investigators analyzed comments received from the study's participants to further shed light on barriers to care, which included everything from long on-hold times to difficult interactions with clinic receptionists during phone calls seeking appointments.

Read More

Predictive Model Identifies Patients for Genetic Testing

Patients who, perhaps unbeknownst to their health care providers, are in need of genetic testing for rare undiagnosed diseases can be identified en masse based on routine information in electronic health records (EHRs), a research team reported today in the journal Nature Medicine.

Read More

AMA Announces New Effort Aimed at Standardizing Blood Pressure Measurement Training at Medical and Health Profession Schools Across the U.S.

New e-learning modules provide consistent, evidence-based BP measurement techniques for students at health care schools nationwide--addressing gaps in current training to improve national blood pressure control rates

Read More

Email Print



Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: