Browsing by Author "Pilling, Russell"
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- ItemOpen AccessCorrection: Development and validation of a case definition for problematic menopause in primary care electronic medical records(2023-10-19) Pham, Anh N.; Cummings, Michael; Yuksel, Nese; Sydora, Beate; Williamson, Tyler; Garies, Stephanie; Pilling, Russell; Lindeman, Cliff; Ross, Sue
- ItemOpen AccessDevelopment and validation of a case definition for problematic menopause in primary care electronic medical records(2023-10-05) Pham, Anh N.; Cummings, Michael; Yuksel, Nese; Sydora, Beate; Williamson, Tyler; Garies, Stephanie; Pilling, Russell; Lindeman, Cliff; Ross, SueAbstract Background Menopause is a normal transition in a woman’s life. For some women, it is a stage without significant difficulties; for others, menopause symptoms can severely affect their quality of life. This study developed and validated a case definition for problematic menopause using Canadian primary care electronic medical records, which is an essential step in examining the condition and improving quality of care. Methods We used data from the Canadian Primary Care Sentinel Surveillance Network including billing and diagnostic codes, diagnostic free-text, problem list entries, medications, and referrals. These data formed the basis of an expert-reviewed reference standard data set and contained the features that were used to train a machine learning model based on classification and regression trees. An ad hoc feature importance measure coupled with recursive feature elimination and clustering were applied to reduce our initial 86,000 element feature set to a few tens of the most relevant features in the data, while class balancing was accomplished with random under- and over-sampling. The final case definition was generated from the tree-based machine learning model output combined with a feature importance algorithm. Two independent samples were used: one for training / testing the machine learning algorithm and the other for case definition validation. Results We randomly selected 2,776 women aged 45–60 for this analysis and created a case definition, consisting of two occurrences within 24 months of International Classification of Diseases, Ninth Revision, Clinical Modification code 627 (or any sub-codes) OR one occurrence of Anatomical Therapeutic Chemical classification code G03CA (or any sub-codes) within the patient chart, that was highly effective at detecting problematic menopause cases. This definition produced a sensitivity of 81.5% (95% CI: 76.3-85.9%), specificity of 93.5% (91.9-94.8%), positive predictive value of 73.8% (68.3-78.6%), and negative predictive value of 95.7% (94.4-96.8%). Conclusion Our case definition for problematic menopause demonstrated high validity metrics and so is expected to be useful for epidemiological study and surveillance. This case definition will enable future studies exploring the management of menopause in primary care settings.
- ItemOpen AccessFood Security in the Northwest Territories: A Market Competition Evaluation(2022-11-10) Pilling, Russell; Fellows, KentIn this capstone project, I examine food prices in the Northwest Territories (NWT) through a competition lens and make policy suggestions to improve Northern food security based on the findings. I primarily focus on assessing food prices through retail food competition, and secondarily on harvesting as a food source. Harvesting is important to include as it affects food security (and market competition) but is less easily captured by economic data. Despite examination through a competition lens, I find that remoteness, and thereby shipping costs, play a dominant role in NWT food prices. The number of food stores in a community plays an insignificant role (statistically and in effect) compared to remoteness. Harvesting supports appear to be a helpful policy option to pursue; however, further evaluation is needed to assess trade-offs and to target policies to specific demographics and communities.