Machine learning for predicting crohn's disease from routine blood tests years before diagnosis: results from the epi-IIRN cohort.

Objectives: In this nationwide study, we used the epi-Israeli Inflammatory Bowel Disease (IBD) Research Nucleus (IIRN) validated cohort to explore the utility of routine blood tests as markers predicting IBD occurrence years before diagnosis.

Methods: We included all health maintenance organization (HMO)-insured IBD patients in Israel diagnosed during 2005-2020 to identify discriminative results of blood tests performed up to 15 years before diagnosis. Each patient was individually matched to two non-IBD controls.

The active cohort: a population-based smartphone intervention for health outcomes.

Background: The Clalit Active Cohort Study (CACS) assess the impact of lifestyle factors, particularly physical activity, on short- and long-term health outcomes using real-world data. Launched in January 2021, CACS focuses on Clalit Health Services members with supplemental health insurance who use the Clalit Active smartphone app.

Methods: The study integrates data from the Clalit Active app with electronic health records from CHS, covering primary and secondary care, hospitalizations, medications, laboratory results, and imaging.

Genetics first approach: Expanding the utility of genetic testing by nongeneticist physicians.

Purpose: The increasing demand for genetic testing and a global shortage of geneticists has significantly strained health care systems worldwide. This highlighted the need for new strategies aiming to increase testing accessibility, reduce wait times, and enhance patient care quality.

Methods: We implemented a 4-step program, "Genetics First," to empower nongeneticist physicians (NGPs) to play an active role in the process of genetic consultation and testing.

Can we identify individuals at risk to develop multiple myeloma? A machine learning-based predictive model.

Multiple myeloma evolves unnoticed over years, and when diagnosed, organ damage is common. Electronic health records (EHR) can help in developing predictive models identifying 'healthy' people at risk. MM patients from Clalit Health Services (2002-2019) were matched with healthy controls.

Real-world impact of physical activity reward-driven digital app use on cardiometabolic and cardiovascular disease incidence.

Background: The lack of effective tools available to health providers for enhancing patient physical activity prompts this study to examine the real-world impact of a physical activity reward-driven app on health outcomes, utilizing Electronic Health Records (EHR) data from Israel's largest healthcare organization.

Methods: Conducting a retrospective cohort study, we matched app-users to non-users based on demographic and clinical characteristics.

Results: App-users have a significantly lower risk of cardiovascular disease (HR 0.

Safety and effectiveness of MVA-BN vaccination against mpox in at-risk individuals in Germany (SEMVAc and TEMVAc): a combined prospective and retrospective cohort study.

Background: More than 115 000 cases of mpox have been confirmed since the onset of a global outbreak in 2022. In addition to global transmission of clade II monkeypox virus (MPXV), the recent spread of clade I has caused a Public Health Emergency of International Concern. The third-generation smallpox vaccine modified vaccinia Ankara-Bavarian Nordic (MVA-BN) was recommended for at-risk populations in 2022, despite a scarcity of data on safety and effectiveness against mpox.

A scoping review and expert consensus on digital determinants of health.

Objective: To map how social, commercial, political and digital determinants of health have changed or emerged during the recent digital transformation of society and to identify priority areas for policy action.

Methods: We systematically searched MEDLINE, Embase and Web of Science on 24 September 2023, to identify eligible reviews published in 2018 and later. To ensure we included the most recent literature, we supplemented our review with non-systematic searches in PubMed® and Google Scholar, along with records identified by subject matter experts.

Effectiveness of AZD7442 (Tixagevimab/Cilgavimab) for Pre-Exposure Prophylaxis Against COVID-19 Hospitalization in Israel During the Omicron Sub-Variant Time Period.

Introduction: The effectiveness of AZD7442 (tixagevimab/cilgavimab) against COVID-19 hospitalizations was determined at 3 and 6 months among immunocompromised individuals in Israel during different variant circulations.

Methods: This was a retrospective cohort study using data from Clalit Health Services in Israel. Immunocompromised individuals eligible to receive AZD7442 300 mg between 15 February and 11 December 2022 were identified.

ClinVec: Unified Embeddings of Clinical Codes Enable Knowledge-Grounded AI in Medicine.

Integrating structured clinical knowledge into artificial intelligence (AI) models remains a major challenge. Medical codes primarily reflect administrative workflows rather than clinical reasoning, limiting AI models' ability to capture true clinical relationships and undermining their generalizability. To address this, we introduce , a clinical knowledge graph that integrates eight EHR-based vocabularies, and , a set of 153,166 clinical code embeddings derived from using a graph transformer neural network.

Trends of common laboratory biomarkers after SARS-CoV-2 infection.

Background: Most studies that explore the long-term effects of COVID-19 are based on subjectively reported symptoms, while laboratory-measured biomarkers are mainly examined in studies of relatively small cohorts. This study investigates the long-term effects of SARS-CoV-2 infection on common laboratory biomarkers.

Methods: We utilized a retrospective cohort of SARS-CoV-2 infected individuals and rigorously matched controls based on demographic and clinical characteristics, examining 63 common laboratory biomarkers.

Randomised immunogenicity trial comparing 2019-2020 recombinant and egg-based influenza vaccines among frequently vaccinated healthcare personnel in Israel.

Objectives: Trivalent inactivated influenza vaccine effectiveness was low in a prospective cohort of healthcare personnel (HCP) in Israel from 2016 to 2019. We conducted a randomised immunogenicity trial of quadrivalent recombinant influenza vaccine (RIV4) and standard-dose inactivated influenza vaccine (IIV4) among frequently and infrequently vaccinated previous cohort participants.

Methods: From October 2019 to January 2020, we enrolled and randomly allocated HCP from two Israeli hospitals to receive IIV4 or RIV4.

Incidence of laboratory-confirmed influenza and RSV and associated presenteeism and absenteeism among healthcare personnel, Israel, influenza seasons 2016 to 2019.

BackgroundHealthcare personnel (HCP) are at high risk for respiratory infections through occupational exposure to respiratory viruses.AimWe used data from a prospective influenza vaccine effectiveness study in HCP to quantify the incidence of acute respiratory infections (ARI) and their associated presenteeism and absenteeism.MethodsAt the start and end of each season, HCP at two Israeli hospitals provided serum to screen for antibodies to influenza virus using the haemagglutination inhibition assay.

Implementation of AZD7442 (Tixagevimab/Cilgavimab) COVID-19 Pre-exposure Prophylaxis (PrEP) in the Largest Health Maintenance Organization in Israel: Real-world Uptake and Sociodemographic and Clinical Characteristics Across Immunocompromised Patient Groups.

Introduction: AZD7442 is a combination of two neutralizing antibodies (tixagevimab/cilgavimab) with demonstrated efficacy in reducing the risk of symptomatic coronavirus disease 2019 (COVID-19) among individuals at high risk of severe COVID-19 ≤ 6 months after administration. On February 15, 2022, the Israeli Ministry of Health (IMoH) authorized the administration of 300 mg AZD7442 as pre-exposure prophylaxis (PrEP) against severe acute respiratory syndrome coronavirus 2 infection among immunocompromised individuals aged ≥ 12 years. This study describes the real-world uptake of AZD7442 in Israel.

Longitudinal machine learning uncouples healthy aging factors from chronic disease risks.

To understand human longevity, inherent aging processes must be distinguished from known etiologies leading to age-related chronic diseases. Such deconvolution is difficult to achieve because it requires tracking patients throughout their entire lives. Here, we used machine learning to infer health trajectories over the entire adulthood age range using extrapolation from electronic medical records with partial longitudinal coverage.

Carrier screening program for pathogenic variants among Ashkenazi Jewish women in Israel: An observational study.

Purpose: The aim of the study was to evaluate the results of a large-scale carrier screening program among Ashkenazi Jewish (AJ) women.

Methods: We performed a cross-sectional study of women who were eligible for screening program. Women who self-reported as complete or partial AJ were screened for 14 pathogenic variants in genes, following the Israeli Ministry of Health's national screening program.

Adoption and utilization of device-assisted telemedicine.

We estimate the effect of adopting a digital device for performing medical exams at home during telehealth visits. We match visits of adopters and non-adopters who used the same virtual care clinic but without the device and compare healthcare utilization after the matched visits. We find that device adoption, partially offset by decreased use of other primary care modalities, results in a 12% higher utilization rate of primary care and increased use of antibiotics.

The role of models in the covid-19 pandemic.

Mathematical and statistical models have played an important role in the analysis of data from COVID-19. They are important for tracking the progress of the pandemic, for understanding its spread in the population, and perhaps most significantly for forecasting the future course of the pandemic and evaluating potential policy options. This article describes the types of models that were used by research teams in Israel, presents their assumptions and basic elements, and illustrates how they were used, and how they influenced decisions.

Lifetime risk, life expectancy, and years of life lost to type 2 diabetes in 23 high-income jurisdictions: a multinational, population-based study.

Background: Diabetes is a major public health issue. Because lifetime risk, life expectancy, and years of life lost are meaningful metrics for clinical decision making, we aimed to estimate these measures for type 2 diabetes in the high-income setting.

Methods: For this multinational, population-based study, we sourced data from 24 databases for 23 jurisdictions (either whole countries or regions of a country): Australia; Austria; Canada; Denmark; Finland; France; Germany; Hong Kong; Hungary; Israel; Italy; Japan; Latvia; Lithuania; the Netherlands; Norway; Scotland; Singapore; South Korea; Spain; Taiwan; the UK; and the USA.

BNT162b2 vaccine effectiveness in chronic kidney disease patients-an observational study.

Background: Chronic kidney disease (CKD) is a risk factor for severe coronavirus disease 2019 (COVID-19). We aimed to evaluate the real-life effectiveness of the BNT162b2 messenger RNA vaccine for a range of outcomes in patients with CKD compared with matched controls.

Methods: Data from Israel's largest healthcare organization were retrospectively used.

Myocarditis following COVID-19 vaccine: incidence, presentation, diagnosis, pathophysiology, therapy, and outcomes put into perspective. A clinical consensus document supported by the Heart Failure Association of the European Society of Cardiology (ESC) and the ESC Working Group on Myocardial and Pericardial Diseases.

Over 10 million doses of COVID-19 vaccines based on RNA technology, viral vectors, recombinant protein, and inactivated virus have been administered worldwide. Although generally very safe, post-vaccine myocarditis can result from adaptive humoral and cellular, cardiac-specific inflammation within days and weeks of vaccination. Rates of vaccine-associated myocarditis vary by age and sex with the highest rates in males between 12 and 39 years.

Nirmatrelvir Use and Severe Covid-19 Outcomes during the Omicron Surge.

Background: The oral protease inhibitor nirmatrelvir has shown substantial efficacy in high-risk, unvaccinated patients infected with the B.1.617.