Although prenatal care has long been viewed as an important strategy toward improving maternal morbidity and mortality, limited data exist that support the premise that access to prenatal care impacts perinatal outcomes. Furthermore, little is known about geographic barriers that impact access to care in an underserved population and how this may influence perinatal outcomes.

By Denisse S. Holcomb, MD, Yolande Pengetnze, MD (PCCI), Ashley Steele, MEd (PCC), Albert Karam, MS (PCCI), Catherine Spong, MD, David B. Nelson, MD

The Parkland Trauma Index of Mortality (PTIM) is a machine learning algorithm that uses electronic medical record (EMR) data to predict 48−hour mortality during the first 72 hours of hospitalization. The model updates every hour, evolving with the patient’s physiologic response to trauma. Area under (AUC) the receiver-operator characteristic curve (ROC), sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and positive and negative likelihood ratios (LR) were used to evaluate model performance. By evolving with the patient’s physiologic response to trauma and relying only on EMR data, the PTIM overcomes many of the limitations of prior mortality risk models. It may be a useful tool to inform clinical decision-making for polytrauma patients early in their hospitalization.

By Adam J. Starr, Manjula Julka, Arun Nethi, John D. Watkins, Ryan W. Fairchild, Michael W. Cripps, Dustin Rinehart, Hayden N. Box

We use an action design research approach to develop an index to assess vulnerability, which incorporates both long-term COVID-19 community risk measures and ongoing dynamic measures of the pandemic. Community and public health officials utilize the index in making critical policy and strategic decisions while guiding their communities during COVID-19 and in future crises. By Thomas Roderick, (PCCI’s Executive in Residence); Yolande Pengetnze (PCCI’s Senior Medical Director); Steve Miff (PCCI’s CEO & President); Monica Chiarini, Tremblay, Rajiv Kohli