Kelli Henry’s research while affiliated with Augusta Health and other places

Purpose: ASHP Residency Standards consider research an important component of residency training. Publication of these projects is considered the gold standard for high quality research; however, residency research publication rates are low, with most reports suggesting less than 12% of projects are successfully published. This study reviewed post-graduate year one (PGY1) research projects to evaluate the role of mentorship in successful publication in peer-reviewed journals. Summary: This was a single-center, observational study of PGY1 research projects between 2010 and 2022 to assess mentorship’s association with publication rate. Successful publication was confirmed via a PubMed search conducted through October 2022. Of 53 included PGY1 research projects, 18 projects (34%) were published, with 12 as manuscript publications and 6 as published abstracts. Projects with mentors with ≥3 publications and with mentors with ≥1 first author publications were associated with higher rates of full publications (excluding projects that were published in abstract form only) (50.0% vs 8.6%, p < 0.001; 37% vs 7.7%, p = 0.001). Faculty member participation also increased manuscript publication (63.6% vs 11.9%, p = 0.008). Publication of PGY1 projects was associated with higher rates of future publications (median 5 vs 1, p < .001). Conclusions: The presence of experienced mentors was associated with successful publication, and publishing a residency project was associated with future publications. New practitioners interested in precepting research projects may benefit from the inclusion of mentors with previous publication experience to support resident research projects.

Background Fluid overload (FO) in the intensive care unit (ICU) is common, serious, and may be preventable. Intravenous medications (including administered volume) are a primary cause for FO but are challenging to evaluate as a FO predictor given the high frequency and time‐dependency of their use and other factors affecting FO. We sought to employ unsupervised machine learning methods to uncover medication administration patterns correlating with FO. Methods This retrospective cohort study included 927 adults admitted to an ICU for ≥72 h. FO was defined as a positive fluid balance ≥7% of admission body weight. After reviewing medication administration record data in 3‐h periods, medication exposure was categorized into clusters using principal component analysis (PCA) and Restricted Boltzmann Machine (RBM). Medication regimens of patients with and without FO were compared within clusters to assess their temporal association with FO. Results FO occurred in 127 (13.7%) of 927 included patients. Patients received a median (interquartile range) of 31(13–65) discrete intravenous medication administrations over the 72‐h period. Across all 47,803 intravenous medication administrations, 10 unique medication clusters, containing 121 to 130 medications per cluster, were identified. The mean number of Cluster 7 medications administered was significantly greater in the FO cohort compared with patients without FO (25.6 vs.10.9, p < 0.0001). A total of 51 (40.2%) of 127 unique Cluster 7 medications were administered in more than five different 3‐h periods during the 72‐h study window. The most common Cluster 7 medications included continuous infusions, antibiotics, and sedatives/analgesics. Addition of Cluster 7 medications to an FO prediction model including the Acute Physiologic and Chronic Health Evaluation (APACHE) II score and receipt of diuretics improved model predictiveness from an Area Under the Receiver Operation Characteristic (AUROC) curve of 0.719 to 0.741 ( p = 0.027). Conclusions Using machine learning approaches, a unique medication cluster was strongly associated with FO. Incorporation of this cluster improved the ability to predict FO compared to traditional prediction models. Integration of this approach into real‐time clinical applications may improve early detection of FO to facilitate timely intervention.