Important Outcomes Research Articles

Classification of postoperative complications in plastic and reconstructive surgery: a systematic review

"Introduction: Postoperative complications are an integral aspect of the surgical audit, being a surrogate marker of surgical quality. Despite demonstrated efficacy in most specialties, there is scarce validation of current systems in plastic and reconstructive surgery, let alone a system unique to the specialty. This review aims to establish the efficacy of current systems in plastic and reconstructive surgery and formulate a classification unique to our specialty. Methods: A PUBMED literature search was performed in January 2023 encompassing all available literature. Search terms included ‘classification’, ‘grading’, ‘postoperative complications’ and ‘adverse events’. Further additions through bibliographic linkage generated a total of 363 articles. Results: Twenty-four papers were related to PRS. Sixteen used current systems to describe postoperative complications, whereas eight papers used a system designed uniquely for PRS. The downfall of conventional systems is the simplicity of return to the operating theatre, constituting a single grade in the Clavien-Dindo Classification. Return to theatre has a broad scope for heterogeneity in plastic and reconstructive surgery, particularly in reconstructive patients. A modification of the Clavien-Dindo Classification is proposed. Conclusion: There is limited efficacy of current classification systems for postoperative complications in plastic and reconstructive surgery nor a well-validated system unique to the specialty. A modified system with a detailed emphasis on return to the theatre will be of value to plastic and reconstructive surgery and ideally correlate with important outcomes. This will be validated in a retrospective review of the complication audit from the developing institution."

The role of relationship beliefs in predicting levels and changes of relationship satisfaction

Relationship beliefs (i.e., destiny and growth beliefs) are associated with important relationship outcomes. Destiny beliefs describe the belief that a relationship is meant to be while growth beliefs describe the tendency that relationships can be cultivated and maintained through effort. Based on a longitudinal sample of people in romantic relationships ( N = 904 couples), we examined whether destiny and growth beliefs predict current levels and trajectories of relationship satisfaction across 2 years. Using dyadic growth curve models, we found that individuals with stronger destiny beliefs generally reported higher initial relationship satisfaction. Furthermore, those with higher growth beliefs experienced a slower decline in relationship satisfaction over time. Vice versa, higher relationship satisfaction also predicted increases in growth beliefs, but not destiny beliefs over time. These findings were also supported when directly asking participants about their subjectively perceived trajectories of relationship satisfaction: Growth beliefs, but not destiny beliefs, went along with the perception that relationship satisfaction has increased in the past and will further increase in the future. The findings suggest that relationship beliefs are relevant for long-term outcomes and could have important implications for developing interventions to help couples maintain relationship satisfaction in the long term.

Pulmonary Rehabilitation: A Look Back, a Look Forward.

Pulmonary rehabilitation (PR) is a comprehensive approach to the management of patients with chronic lung disease that encompasses exercise, education, and psychosocial support. The development of PR programs began in the mid-20th century with the appreciation that exercise provided real benefit in chronic lung disease and that effective disease management involved patient education focused on medications, lifestyle changes, and lifelong regular exercise. Initially PR was primarily facility-based, but today PR is extending into the home with telemedicine, and this is encouraging a real partnership of patients and professionals supporting self-management. The evidence base supporting PR as a safe and effective modality has grown exponentially over the last 4 decades, and PR is strongly endorsed by virtually all the major professional societies. Importantly, PR has also clearly been shown to be cost-effective. Challenges remain, however. Access is still very limited for a variety of reason (logistics, financial, patient motivation) that need to be addressed. More focused and personalized exercise programs and monitoring strategies that encourage a patient's lifetime commitment to the principles of PR need to be developed and refined. The opportunity to really impact important clinical outcomes exists with PR, and this needs to be exploited.

Emotions or cognitions first? Longitudinal relations between executive functions and emotion regulation in childhood.

Executive functions and emotion regulation develop from early childhood to adolescence and are predictive of important psychosocial outcomes. However, despite the correlation between the two regulatory capacities, whether they are prospectively related in school-aged children remains unknown, and the direction of effects is uncertain. In this study, a sample drawn from two birth cohorts in Norway was biennially examined between the ages of 6 and 14 (n = 852, 50.1% girls, 93% Norwegian). Parents completed the Emotion Regulation Checklist, and teachers completed the Behavior Rating Inventory of Executive Function. A random intercept cross-lagged panel model revealed that improved emotion regulation predicted increased executive functioning to the same extent throughout development, whereas enhanced executive functioning was unrelated to future changes in emotion regulation.

Effectiveness of substance use disorder treatment as an alternative to imprisonment

IntroductionDrug courts are criminal justice programs to divert people with substance use disorders from incarceration into treatment. Drug courts have become increasingly popular in the US and other countries. However, their effectiveness in reducing important public health outcomes such as recidivism and substance-related health harms remains ambiguous and contested. We used nationwide register data from Sweden to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism.MethodsIn this prospective cohort study, two quasi-experimental designs were used: difference-in-differences and the within-individual design. In the latter, we compared the risk of outcomes during time on contract treatment to, 1) parole after imprisonment and, 2) probation.ResultsThe cohort included 11,893 individuals (13% women) who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points (95% CI: -.088, -.055) in substance misuse, 5 percentage points (-.064, -.034) in adverse mental health events, 9 percentage points (-.113, -.076) in adverse somatic health events, and 3 fewer charges (-3.16, -2.85) for crime in difference-in-differences analyses. Within-individual associations suggested that the same individual had longer times-to-event for all outcomes during contract treatment than on parole or on probation.ConclusionsContract treatment is an effective intervention from both public health and criminal justice perspective. Our findings suggest that it is a superior alternative to incarceration in its target group. Further, we find that an implementation approach that is less punitive and more inclusive than what is typical in the US can be successful.

Contemporary trends in incident ischemic stroke, intracranial hemorrhage, and mortality in individuals with atrial fibrillation.

The prognosis for atrial fibrillation (AF) patients is based on data that is decades old. Given evolving standards of clinical practice, we sought to evaluate temporal trends in clinically important outcomes among patients with AF. California's Department of Health Care Access and Information databases were used to identify adults aged≥18 years with AF receiving hospital-based care in California. We compared 3 time-periods: 2005-2009, 2010-2014, and 2015-2019. ICD codes were used to identify chronic diseases and acute events. The outcomes were incident ischemic stroke, intracranial hemorrhage, and overall mortality. We included 2009832 patients with AF (52.7% males, 70.7% Whites, and mean age of 75.0 years), divided in 3 cohorts: 2005-2009 (n=738954), 2010-2014 (n=609447), and 2015-2019 (n=661431). Each outcome became substantially less common with time: compared to 2005-2009, AF patients diagnosed in 2015-2019 experienced a 34% (adjusted hazard ratio [HR] 0.66, 95% CI 0.64-0.69), 22% (HR 0.78, 0.75-0.82), and 24% (HR 0.76, 0.75-0.77) reduction in risk of incident ischemic stroke, intracranial hemorrhage, and mortality, respectively. Between 2005-2009 and 2015-2019, patients aged≥65 years experienced more reductions in each outcome compared to younger patients (p<0.001 for all), and declines in each outcome were significantly lower for Hispanics and Blacks compared to white patients. The risks of stroke, intracranial hemorrhage, and death have significantly declined among AF patients, although differences in the magnitude of improvement of these outcomes by demographic groups were observed. Commonly described estimates of the prognosis for AF patients should be updated to reflect contemporary care.

Collaboration in agricultural value chains: a scoping review of the evidence from developing countries

PurposeCollaboration in agricultural value chains (AVCs) has the potential to increase smallholders’ participation in international value chains and increase their benefits from participation. This scoping review explores existing collaboration models among stakeholders of AVCs in developing countries, examines enablers and constraints of collaboration and identifies policy gaps.Design/methodology/approachWe systematically searched three databases, CAB Abstracts, Econlit (EBSCO) and Agricola, for studies published between 2005 and 2023 and included 59 relevant studies on AVC collaboration.FindingsThe primary motivations for collaboration are to enhance market access and improve product quality. Key outcomes of collaboration include improvements in farmers’ welfare, market participation and increased production; only a few studies consider improved risk management as an important outcome. Robust support from government and non-governmental entities is a primary enabler of collaboration. Conversely, conflicts of interest among stakeholders and resource limitations constrain collaboration possibilities. Collaboration involving high-value crops prioritizes income increases, whereas collaboration involving staple crops focuses on improving household food security.Research limitations/implicationsThis study may have publication bias as unsuccessful instances of collaboration are less likely to be published.Originality/valueThis study is unique in highlighting collaboration models’ characteristics and identifying AVC policy and programmatic areas where private firms, farmers’ groups, local governments and donor agencies can contribute.

Renal Denervation for Uncontrolled Hypertension

What Is the Issue?&#x0D; &#x0D; It is estimated that 23% of adults in Canada have hypertension. About 1/3 of this population have uncontrolled hypertension, a condition in which (BP) blood pressure levels continue to remain high despite treatment. People with high BP despite being prescribed 3 or more blood pressure-lowering (antihypertensive) medicines are considered to have uncontrolled resistant hypertension.&#x0D; Renal denervation is a therapy that involves disrupting activity in the sympathetic nerves in the renal artery using a minimally invasive catheter-based procedure to treat high BP.&#x0D; We wanted to know if renal denervation would effectively and safely reduce BP in people with uncontrolled hypertension.&#x0D; &#x0D; What Did We Do?&#x0D; &#x0D; We identified and summarized the literature comparing the clinical effectiveness and safety of renal denervation in individuals with uncontrolled hypertension to help guide decisions on the use of this intervention.&#x0D; An information specialist searched for peer-reviewed and grey literature sources published between January 1, 2019, and February 5, 2024. The search was limited to English-language documents. One reviewer screened articles for inclusion based on predefined criteria, critically appraised the included studies, and narratively summarized the findings.&#x0D; &#x0D; What Did We Find?&#x0D; &#x0D; The evidence for this report was based on 2 systematic reviews and 3 randomized controlled trials (RCTs).&#x0D; Renal denervation could lead to a reduction in BP compared to sham in adults with uncontrolled nonresistant hypertension.&#x0D; It is uncertain if renal denervation is an effective treatment for resistant hypertension and suspected hypertensive heart disease due to the methodological limitations of the included studies.&#x0D; Serious side effects of renal denervation were rare.&#x0D; &#x0D; What Does This Mean?&#x0D; &#x0D; Our findings agree with evidence-based guidelines and real-world evidence that suggest renal denervation can be considered a treatment option for patients with uncontrolled nonresistant hypertension. Other factors, including costs and resources, equity, acceptability, and patient selection, should be considered when implementing renal denervation in Canada, where it remains an emerging medical technology.&#x0D; Future research should assess important patient outcomes, such as quality of life.&#x0D;

Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER

PurposeEvaluate long-term efficacy and safety of elamipretide during the open-label extension (OLE) of the TAZPOWER trial in individuals with Barth syndrome (BTHS). MethodsTAZPOWER was a 28-week randomized, double-blind, and placebo-controlled trial followed by a 168-week OLE. Patients entering the OLE continued elamipretide 40 mg subcutaneous daily. OLE primary endpoints were safety and tolerability; secondary endpoints included change from baseline in the 6-minute walk test (6MWT) and BarTH Syndrome Symptom Assessment (BTHS-SA) Total Fatigue score. Muscle strength, physician- and patient-assessed outcomes, echocardiographic parameters, and biomarkers, including cardiolipin (CL) and monolysocardiolipin (MLCL), were assessed. ResultsTen patients entered the OLE; 8 reached the week 168 visit. Elamipretide was well tolerated, with injection-site reactions being the most common adverse events. Significant improvements from OLE baseline on 6MWT occurred at all OLE time points (cumulative 96.1 m of improvement [week 168, P = .003]). Mean BTHS-SA Total Fatigue scores were below baseline (improved) at all OLE time points. Three-dimensional (3D) left ventricular stroke, end-diastolic, and end-systolic volumes improved, showing significant trends for improvement from baseline to week 168. MLCL/CL values showed improvement, correlating to important clinical outcomes. ConclusionElamipretide was associated with sustained long-term tolerability and efficacy, with improvements in functional assessments and cardiac function in BTHS.

Self-harm presentations to hospital trauma centre emergency departments during the first year of the COVID-19 pandemic

The COVID-19 pandemic raised concerns regarding increased suicide-related behaviours. We compared characteristics and counts of Emergency Department (ED) presentations for self-harm, an important suicide-related outcome, during versus prior to the pandemic's first year. We included patients presenting with self-harm to the ED of two trauma centres in Toronto, Canada. Time series models compared intra-pandemic (March 2020-February 2021) presentation counts to predictions from pre-pandemic data. The self-harm proportion of ED presentations was compared between the intra-pandemic period and preceding three years. A retrospective chart review of eligible patients seen from March 2019-February 2021 compared pre- vs. intra-pandemic patient and injury characteristics. While monthly intra-pandemic self-harm counts were largely within expected ranges, the self-harm proportion of total presentations increased. Being widowed (OR=9.46; 95 %CI=1.10–81.08), employment/financial stressors (OR=1.65, 95 %CI=1.06–2.58), job loss (OR=3.83; 95 %CI=1.36–10.76), and chest-stabbing self-harm (OR=2.50; 95 %CI=1.16–5.39) were associated with intra-pandemic presentations. Intra-pandemic self-harm was also associated with Intensive Care Unit (ICU) admission (OR=2.18, 95 %CI=1.41–3.38). In summary, while the number of self-harm presentations to these trauma centres did not increase during the early pandemic, their proportion was increased. The association of intra-pandemic self-harm with variables indicating medically severe injury, economic stressors, and being widowed may inform future suicide and self-harm prevention strategies.

Translation and validation of the Chinese self-report version of Spinal Cord Independence Measure (SCIM-SR): Rasch psychometric analysis and online application

Spinal Cord Independence Measure (SCIM) was an important functional outcome measure specifically designed for spinal cord injury (SCI) patients, with the self-reported version of SCIM (SCIM-SR) published in 2013. This study aims to translate the SCIM-SR into Chinese, and to investigate the validity of Chinese SCIM-SR among SCI patients. This Chinese version of SCIM-SR was translated into Chinese in a standardized approach, and then filled out by a sample of patients with SCI (n = 205) within 3 days after admission. Validity of Chinese SCIM-SR was then analyzed using Rasch analysis and principal component analysis. The subscale Selfcare and subscale Mobility showed good fit to the Rasch model, with no significance found in Chi-square test results for item-trait interaction, using Bonferroni adjustment for the significant level (χ2 =18.125, P = 0.111; χ2 =33.629, P = 0.006). Mean fit residual for items and persons of each subscale were within ± 2.5. The model fit of the subscale of Respiration and Sphincter Management was not satisfactory even after deleting one item and merging two items with local dependence. However, Kaiser-Meyer-Olkin test was > 0.50 in total score and all the subscales of Chinese SCIM-SR, and P < 0.05 in the Bartlett’s test. There was no differential item functioning for gender, time post injury, age, and etiology in any of the three subscales. An online version of Chinese SCIM-SR was also developed. It is concluded that the SCIM-SR in Chinese is valid for application in individuals with SCI. SCIM-SR is considered as an important tool for self-reporting functional status from SCI individuals’ perspective.

Pubertal Suppression in Early Puberty Followed by Testosterone Mildly Increases Final Height in Transmasculine Youth.

Treatment for transmasculine youth (TMY) can involve testosterone treatment and is sometimes preceded by gonadotropin-releasing hormone agonist (GnRHa) treatment for puberty blockade. GnRHas can increase final height in birth-assigned females with central precocious puberty. Maximizing final adult height (FAH) is an important outcome for many TMY. Our objective was to determine how GnRHa treatment before testosterone impacts FAH. Retrospective cohort study at 5 US transgender health clinics. Participants were 32 TMY treated with GnRHas in early to midpuberty before testosterone (GnRHa + T group) and 62 late/postpubertal TMY treated with testosterone only (T-only group). The difference between FAH minus midparental target height (MPTH) was +2.3 ± 5.7 cm and -2.2 ± 5.6 cm in the GnRHa + T and T-only groups, respectively (P < .01). In the GnRHa + T group, FAH was 1.8 ± 3.4 cm greater than predicted adult height (PAH) (P < .05) and FAH vs initial height (IH) z-score was 0.5 ± 1.2 vs 0.16 ± 1.0 (P < .05). After adjusting for patient characteristics, each additional month of GnRHa monotherapy increased FAH by 0.59 cm (95% CI 0.31, 0.9 cm), stage 3 breast development at start of GnRHa was associated with 6.5 cm lower FAH compared with stage 2 (95% CI -10.43, -2.55), and FAH was 7.95 cm greater in the GnRHa + T group than in T-only group (95% CI -10.85, -5.06). Treatment with GnRHa in TMY in early puberty before testosterone increases FAH compared with MPTH, PAH, IH, and TMY who only received testosterone in late/postpuberty. TMY considering GnRHas should be counseled that GnRHas may mildly increase their FAH if started early.

How to measure patient and family important outcomes in extremely preterm infants: A scoping review.

Parents of children born preterm have identified outcomes to be measured for audit and research at 18-24 months of age: child well-being, quality of life/function, socio-emotional/behavioural outcomes, respiratory, feeding, sleeping, and caregiver mental health. The aim was to identify the best tools to measure these seven domains. Seven working groups completed literature reviews and evaluated potential tools to measure these outcomes in children aged 18-24 months. A group of experts and parents voted on the preferred tools in a workshop and by questionnaire. Consensus was 80% agreement. Consensus was obtained for seven brief, inexpensive, parent friendly valid measures available in English or French for use in a minimum dataset and potential alternative measures for use in funded research. Valid questionnaires and tools to measure parent-identified outcomes in young preterm children exist. This study will facilitate research and collection of data important to families.

Creating a space for the sacred in a secular world: Shabbat dinners as a vehicle for collective effervescence, social connection, and meaning

Scholars have long argued that religious rituals are essential for maintaining society, bringing meaning to life and increasing connections via the collective effervescence that they engender. A world in which fewer people attend religious services does not mean that people no longer benefit from the important outcomes associated with religious rituals. The current research examined whether people experience collective effervescence and positive outcomes in home-based rituals—specifically, Shabbat dinners facilitated by a Jewish organization that provides resources for home-based Shabbat dinners. Survey data was collected on almost 1000 attendees of the Shabbat dinners. The results suggest that (a) Shabbat dinners include both components of collective effervescence (a sensation of sacredness and connection to others); (b) “transcendence” collective effervescence was related to religiosity and meaningfulness, whereas “connectedness”collective effervescence was related to belonging and satisfaction; and (c) using instructional resources predicted increased meaning via religiosity and increased satisfaction via belonging. The authors conclude that home-based rituals can provide valuable outcomes in a world in which people are less likely to attend religious services.

Depression in Rheumatoid Arthritis: Prevalence and Effects on Disease Activity.

Background:The primary objective of this study was to estimate depression's prevalence in a cohort of rheumatoid arthritis (RA) patients, and the secondary objective was to evaluate the impact of depression on disease activity over time. Methods: We included all patients with RA presenting to our clinic from 2019 to 2020, who had three follow-up visits available. Depression prevalence was calculated using the patient's history of diagnosed depression, and disease activity was assessed using the disease activity score for 28 joints (DAS28) and its components: tender joint count (TJC), swollen joint count (SJC), pain value on a visual analog scale (VAS), and inflammatory markers. Results: A total of 400 RA patients were included, 75 of whom had diagnosed depression, generating a prevalence of 18.8%. The mean values of DAS28 and its components were higher, with statistical significance, in the depression subgroup at all three follow-ups (p < 0.001). Conclusions: Depression is prevalent in the RA population, and leads to higher disease activity in dynamic evaluations. Assessing depression could be a psychological marker for RA prognosis with an important outcome in controlling disease activity.

Sustainable and modern bio-based technologies: new approachs to food safety and security

AbstractTwo major challenges in the modern world are ensuring food security and using sustainability in limited areas, in the face of climate change and population growth. It is aimed to raise awareness on the importance of working from a multidisciplinary perspective, together with developing technology and science, in solving current problems/troubles, and that the simultaneous use of modern bio-based technologies with innovative techniques will ensure an effective role in overcoming many difficulties that future generations will face, as well as sustainability can be achieved. The review provides a detailed systematic review and analysis of the mutually supportive use of modern bio-based technologies and sustainable agricultural system technologies within the framework of this subject. The review, in which universally reliable databases were used, was carried out using information obtained from practice and approach-based articles (&gt; 4000). The fact that the main topic has the lowest publication content in terms of "sustainability and biotechnology" according to the analysis carried out within the determined keywords indicates the need for additional research and applications and to contribute to the literature. Similar to review aim, it has also been concluded that the development of a multidisciplinary, interdisciplinary and transdisciplinary perspective that provides a comprehensive and broader focus on eliminating the deficiencies in the fields will play a major role in solving problems related to the sustainability of food safety and security. Thus, contributing to the protection of world food security should be considered as another important outcome that should not be forgotten. In short, being aware that the world, especially its resources, are not infinite and for the continuity of healthy generations, the sustainability of the world, food and agriculture, food safety and security must be meticulously protected, developed with innovative technologies and also carried a step forward by developing more effective strategies in this field of work, which is of great importance for life.

The strengths and limitations of using quantitative data to inform school inspections

ABSTRACT School inspections are a common feature of many education systems. These may be informed by quantitative background data about schools. It is recognised that there are pros and cons of using such quantitative information as part of the inspection process, though these have rarely been succinctly set out. This paper seeks to fill this gap by presenting arguments both for and against the use of quantitative data in informing school inspections. We argue that while quantitative data provide objective information about important outcomes, their usefulness is limited somewhat by a range of factors including missing data, small sample sizes, the creation of perverse incentives, and the fact that most readily available measures capture aspects other than school quality. We conclude by discussing how the Office for Standards in Education, Children’s Services and Skills (Ofsted) – the school inspectorate in England – currently makes the trade-off between these pros and cons.

Diurnal 11-ketotestosterone and 17-hydroxyprogesterone saliva profiles in paediatric classical congenital adrenal hyperplasia.

The most suitable biochemical markers for therapy adjustment in patients with congenital adrenal hyperplasia are controversial. 11-Oxygenated androgens are a promising new approach. The objective of this study was to investigate the diurnal rhythm of 11-ketotestosterone in children and adolescents in saliva and to correlate it with salivary 17-hydroxyprogesterone. Fifty-one samples of steroid day-profiles from 17 patients were additionally analysed for 11-ketotestosterone, retrospectively. All patients were treated in our university outpatient clinic for paediatric endocrinology between 2020 and 2022. Steroid day-profiles of 17 patients could be examined. The cohort showed a balanced sex ratio. The median age was 13 years. The measurements for 17-hydroxyprogesterone were carried out during routine care by immunoassay. The measurements of 11-ketotestosterone were performed from frozen saliva samples using an implemented in-house protocol for liquid chromatography-tandem mass spectrometry (LC-MS/MS). The most important outcome were the absolute values for 11-ketotestosterone, their diurnal rhythmicity and the correlation with 17-hydroxyprogesterone. Both steroids show a circadian diurnal rhythm. 17-hydroxyprogesterone and 11-ketotestosterone correlate significantly. 11-Ketotestosterone showed a positive correlation with BMI at all times of the day. 11-Ketotestosterone shows circadian rhythmicity in our cohort and correlates with 17-hydroxyprogesterone. These findings serve as an important basis for prospective research into 11-oxygenated androgens as therapeutic markers in paediatrics. However, 11-ketotestosterone appears to be very dependent on BMI.

Understanding the Distributions of Aggregation Layers in Deep Neural Networks.

The process of aggregation is ubiquitous in almost all the deep nets' models. It functions as an important mechanism for consolidating deep features into a more compact representation while increasing the robustness to overfitting and providing spatial invariance in deep nets. In particular, the proximity of global aggregation layers to the output layers of DNNs means that aggregated features directly influence the performance of a deep net. A better understanding of this relationship can be obtained using information theoretic methods. However, this requires knowledge of the distributions of the activations of aggregation layers. To achieve this, we propose a novel mathematical formulation for analytically modeling the probability distributions of output values of layers involved with deep feature aggregation. An important outcome is our ability to analytically predict the Kullback-Leibler (KL)-divergence of output nodes in a DNN. We also experimentally verify our theoretical predictions against empirical observations across a broad range of different classification tasks and datasets.

80 Venous thromboembolism diagnosis definition in claims data: implications for research

OBJECTIVES/GOALS: Venous thromboembolism (VTE) is a major cause of morbidity and mortality. Due to its relatively low incidence, prospective studies are limited. This makes administrative claims a promising data source to study VTE. We sought to examine the reproducibility of results using different VTE definitions from the published literature. METHODS/STUDY POPULATION: We conducted a retrospective analysis of a random 10% sample of the 2010-2022 IQVIA LifeLink PharMetrics Plus™ database, an administrative claims database representative of the commercially insured population of the United States. We selected cancer patients undergoing major gastrointestinal surgery, who have a higher risk for postoperative VTE (deep venous thrombosis [DVT] and/or pulmonary embolism [PE]). VTE was defined using ICD-9-CM and ICD-10-CM codes using definitions from 4 individual published studies. We compared the 4 definitions with respect to the incidence of VTE and factors associated with post-discharge VTE using standard univariate and multivariable logistic regression models. The same logistic regression models were used for each of the 4 definitions. RESULTS/ANTICIPATED RESULTS: There were substantial differences in VTE coding among the 4 definitions (range 107 to 225 ICD-9/10 codes for DVT and 12 to 24 codes for PE). The eligible population comprised 2,360 patients (49% female) with a median age of 49 years (interquartile range 47-52 years). During the index surgery hospitalization, a total of 58, 62, 63, and 83 patients developed VTE using the 4 definitions. In the 2,126 patients eligible for VTE prophylaxis, a total of 108, 68, 73, and 107 patients developed post-discharge VTE (range for DVT 35 to 81, range for PE 39 to 76). On multivariable analysis, factors independently associated with VTE included age using 1 of 4 definitions, esophageal surgery type using 3 of 4 definitions, and liver surgery type and Elixhauser score using all 4 definitions. DISCUSSION/SIGNIFICANCE: The incidence of VTE is directly affected by differences in ICD-9/10 codes used. Definitions for important clinical outcomes should be standardized when using administrative claims data in order to improve reproducibility of findings.