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
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 th...
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Hindawi Limited
2018-01-01
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Series: | BioMed Research International |
Online Access: | http://dx.doi.org/10.1155/2018/5051289 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dominique J. Monlezun Lyn Dart Anne Vanbeber Peggy Smith-Barbaro Vanessa Costilla Charlotte Samuel Carol A. Terregino Emine Ercikan Abali Beth Dollinger Nicole Baumgartner Nicholas Kramer Alex Seelochan Sabira Taher Mark Deutchman Meredith Evans Robert B. Ellis Sonia Oyola Geeta Maker-Clark Tomi Dreibelbis Isadore Budnick David Tran Nicole DeValle Rachel Shepard Erika Chow Christine Petrin Alexander Razavi Casey McGowan Austin Grant Mackenzie Bird Connor Carry Glynis McGowan Colleen McCullough Casey M. Berman Kerri Dotson Tianhua Niu Leah Sarris Timothy S. Harlan on behalf of the CHOP Co-investigators |
spellingShingle |
Dominique J. Monlezun Lyn Dart Anne Vanbeber Peggy Smith-Barbaro Vanessa Costilla Charlotte Samuel Carol A. Terregino Emine Ercikan Abali Beth Dollinger Nicole Baumgartner Nicholas Kramer Alex Seelochan Sabira Taher Mark Deutchman Meredith Evans Robert B. Ellis Sonia Oyola Geeta Maker-Clark Tomi Dreibelbis Isadore Budnick David Tran Nicole DeValle Rachel Shepard Erika Chow Christine Petrin Alexander Razavi Casey McGowan Austin Grant Mackenzie Bird Connor Carry Glynis McGowan Colleen McCullough Casey M. Berman Kerri Dotson Tianhua Niu Leah Sarris Timothy S. Harlan on behalf of the CHOP Co-investigators 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 BioMed Research International |
author_facet |
Dominique J. Monlezun Lyn Dart Anne Vanbeber Peggy Smith-Barbaro Vanessa Costilla Charlotte Samuel Carol A. Terregino Emine Ercikan Abali Beth Dollinger Nicole Baumgartner Nicholas Kramer Alex Seelochan Sabira Taher Mark Deutchman Meredith Evans Robert B. Ellis Sonia Oyola Geeta Maker-Clark Tomi Dreibelbis Isadore Budnick David Tran Nicole DeValle Rachel Shepard Erika Chow Christine Petrin Alexander Razavi Casey McGowan Austin Grant Mackenzie Bird Connor Carry Glynis McGowan Colleen McCullough Casey M. Berman Kerri Dotson Tianhua Niu Leah Sarris Timothy S. Harlan on behalf of the CHOP Co-investigators |
author_sort |
Dominique J. Monlezun |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2018-01-01 |
description |
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. |
url |
http://dx.doi.org/10.1155/2018/5051289 |
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doaj-3878a97ce4784659a541c4067ae2682e2020-11-25T01:01:49ZengHindawi LimitedBioMed Research International2314-61332314-61412018-01-01201810.1155/2018/50512895051289Machine 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 YearsDominique J. Monlezun0Lyn Dart1Anne Vanbeber2Peggy Smith-Barbaro3Vanessa Costilla4Charlotte Samuel5Carol A. Terregino6Emine Ercikan Abali7Beth Dollinger8Nicole Baumgartner9Nicholas Kramer10Alex Seelochan11Sabira Taher12Mark Deutchman13Meredith Evans14Robert B. Ellis15Sonia Oyola16Geeta Maker-Clark17Tomi Dreibelbis18Isadore Budnick19David Tran20Nicole DeValle21Rachel Shepard22Erika Chow23Christine Petrin24Alexander Razavi25Casey McGowan26Austin Grant27Mackenzie Bird28Connor Carry29Glynis McGowan30Colleen McCullough31Casey M. Berman32Kerri Dotson33Tianhua Niu34Leah Sarris35Timothy S. Harlan36on behalf of the CHOP Co-investigators37The Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USATexas Christian University, Fort Worth, TX, USATexas Christian University, Fort Worth, TX, USATexas College of Osteopathic Medicine, Fort Worth, TX, USAUniversity of Texas School of Medicine in San Antonio, San Antonio, TX, USAUniversity of Texas School of Medicine in San Antonio, San Antonio, TX, USARutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USARutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USALake Erie College of Osteopathic Medicine, Arnot Ogden Medical Center, Erie, PA, USALake Erie College of Osteopathic Medicine, Arnot Ogden Medical Center, Erie, PA, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAUniversity of Illinois-Chicago College of Medicine, Chicago, IL, USAUniversity of Colorado-Denver School of Medicine, Denver, CO, USAUniversity of Colorado-Denver School of Medicine, Denver, CO, USAWestern University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest, Lebanon, OR, USAUniversity of Chicago Pritzker School of Medicine, Chicago, IL, USAUniversity of Chicago Pritzker School of Medicine, Chicago, IL, USAPennsylvania State University College of Medicine, Hershey, PA, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USATulane University School of Public Health & Tropical Medicine, New Orleans, LA, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USAThe Goldring Center for Culinary Medicine, Tulane University School of Medicine, 300 N. Broad St., Suite 102, New Orleans, LA 70119, USABackground. 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.http://dx.doi.org/10.1155/2018/5051289 |