Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years.

Autor: Monlezun DJ; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA.; Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA., Dart L; Texas Christian University, Fort Worth, TX, USA., Vanbeber A; Texas Christian University, Fort Worth, TX, USA., Smith-Barbaro P; Texas College of Osteopathic Medicine, Fort Worth, TX, USA., Costilla V; University of Texas School of Medicine in San Antonio, San Antonio, TX, USA., Samuel C; University of Texas School of Medicine in San Antonio, San Antonio, TX, USA., Terregino CA; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA., Abali EE; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA., Dollinger B; Lake Erie College of Osteopathic Medicine, Arnot Ogden Medical Center, Erie, PA, USA., Baumgartner N; Lake Erie College of Osteopathic Medicine, Arnot Ogden Medical Center, Erie, PA, USA., Kramer N; Meharry Medical College, Nashville, TN, USA., Seelochan A; Meharry Medical College, Nashville, TN, USA., Taher S; University of Illinois-Chicago College of Medicine, Chicago, IL, USA., Deutchman M; University of Colorado-Denver School of Medicine, Denver, CO, USA., Evans M; University of Colorado-Denver School of Medicine, Denver, CO, USA., Ellis RB; Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest, Lebanon, OR, USA., Oyola S; University of Chicago Pritzker School of Medicine, Chicago, IL, USA., Maker-Clark G; University of Chicago Pritzker School of Medicine, Chicago, IL, USA., Dreibelbis T; Pennsylvania State University College of Medicine, Hershey, PA, USA., Budnick I; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Tran D; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., DeValle N; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Shepard R; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Chow E; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Petrin C; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Razavi A; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., McGowan C; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Grant A; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Bird M; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Carry C; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., McGowan G; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., McCullough C; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Berman CM; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Dotson K; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Niu T; Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA., Sarris L; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Harlan TS; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA., Co-Investigators OBOTC; The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USA.
Jazyk: angličtina
Zdroj: BioMed research international [Biomed Res Int] 2018 Apr 15; Vol. 2018, pp. 5051289. Date of Electronic Publication: 2018 Apr 15 (Print Publication: 2018).
DOI: 10.1155/2018/5051289
Abstrakt: Background: Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students.
Methods: This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies.
Results: 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00-2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07-1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37-0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally ( p < 0.001).
Discussion: This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that the public health and medical sectors can unite population health management and precision medicine for a sustainable model of next-generation health systems providing effective, equitable, accessible care beginning with reversing the CVD epidemic.
Databáze: MEDLINE
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