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Creators/Authors contains: "Austrian, Jonathan"

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  1. Hastings, Janna (Ed.)
    BackgroundHealthcare crowdsourcing events (e.g. hackathons) facilitate interdisciplinary collaboration and encourage innovation. Peer-reviewed research has not yet considered a healthcare crowdsourcing event focusing on generative artificial intelligence (GenAI), which generates text in response to detailed prompts and has vast potential for improving the efficiency of healthcare organizations. Our event, the New York University Langone Health (NYULH) Prompt-a-thon, primarily sought to inspire and build AI fluency within our diverse NYULH community, and foster collaboration and innovation. Secondarily, we sought to analyze how participants’ experience was influenced by their prior GenAI exposure and whether they received sample prompts during the workshop. MethodsExecuting the event required the assembly of an expert planning committee, who recruited diverse participants, anticipated technological challenges, and prepared the event. The event was composed of didactics and workshop sessions, which educated and allowed participants to experiment with using GenAI on real healthcare data. Participants were given novel “project cards” associated with each dataset that illuminated the tasks GenAI could perform and, for a random set of teams, sample prompts to help them achieve each task (the public repository of project cards can be found athttps://github.com/smallw03/NYULH-Generative-AI-Prompt-a-thon-Project-Cards). Afterwards, participants were asked to fill out a survey with 7-point Likert-style questions. ResultsOur event was successful in educating and inspiring hundreds of enthusiastic in-person and virtual participants across our organization on the responsible use of GenAI in a low-cost and technologically feasible manner. All participants responded positively, on average, to each of the survey questions (e.g., confidence in their ability to use and trust GenAI). Critically, participants reported a self-perceived increase in their likelihood of using and promoting colleagues’ use of GenAI for their daily work. No significant differences were seen in the surveys of those who received sample prompts with their project task descriptions ConclusionThe first healthcare Prompt-a-thon was an overwhelming success, with minimal technological failures, positive responses from diverse participants and staff, and evidence of post-event engagement. These findings will be integral to planning future events at our institution, and to others looking to engage their workforce in utilizing GenAI. 
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  2. Abstract Background We previously developed and validated a predictive model to help clinicians identify hospitalized adults with coronavirus disease 2019 (COVID-19) who may be ready for discharge given their low risk of adverse events. Whether this algorithm can prompt more timely discharge for stable patients in practice is unknown. Objectives The aim of the study is to estimate the effect of displaying risk scores on length of stay (LOS). Methods We integrated model output into the electronic health record (EHR) at four hospitals in one health system by displaying a green/orange/red score indicating low/moderate/high-risk in a patient list column and a larger COVID-19 summary report visible for each patient. Display of the score was pseudo-randomized 1:1 into intervention and control arms using a patient identifier passed to the model execution code. Intervention effect was assessed by comparing LOS between intervention and control groups. Adverse safety outcomes of death, hospice, and re-presentation were tested separately and as a composite indicator. We tracked adoption and sustained use through daily counts of score displays. Results Enrolling 1,010 patients from May 15, 2020 to December 7, 2020, the trial found no detectable difference in LOS. The intervention had no impact on safety indicators of death, hospice or re-presentation after discharge. The scores were displayed consistently throughout the study period but the study lacks a causally linked process measure of provider actions based on the score. Secondary analysis revealed complex dynamics in LOS temporally, by primary symptom, and hospital location. Conclusion An AI-based COVID-19 risk score displayed passively to clinicians during routine care of hospitalized adults with COVID-19 was safe but had no detectable impact on LOS. Health technology challenges such as insufficient adoption, nonuniform use, and provider trust compounded with temporal factors of the COVID-19 pandemic may have contributed to the null result. Trial registration ClinicalTrials.gov identifier: NCT04570488. 
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  3. Abstract The COVID-19 pandemic has challenged front-line clinical decision-making, leading to numerous published prognostic tools. However, few models have been prospectively validated and none report implementation in practice. Here, we use 3345 retrospective and 474 prospective hospitalizations to develop and validate a parsimonious model to identify patients with favorable outcomes within 96 h of a prediction, based on real-time lab values, vital signs, and oxygen support variables. In retrospective and prospective validation, the model achieves high average precision (88.6% 95% CI: [88.4–88.7] and 90.8% [90.8–90.8]) and discrimination (95.1% [95.1–95.2] and 86.8% [86.8–86.9]) respectively. We implemented and integrated the model into the EHR, achieving a positive predictive value of 93.3% with 41% sensitivity. Preliminary results suggest clinicians are adopting these scores into their clinical workflows. 
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