Risk Management and Healthcare Policy最新文献

{"title":"Modifiable Lifestyle Risk Factors for Lower Extremity Arteriosclerosis Obliterans in a High-Risk Population: A Retrospective Case-Control Study.","authors":"Yuan Bai, Ting Han, Zhuoxia Li, Xin Wu, Ying Yu, Shujin Zhang","doi":"10.2147/RMHP.S618865","DOIUrl":"10.2147/RMHP.S618865","url":null,"abstract":"<p><strong>Objective: </strong>To identify specific modifiable lifestyle risk factors associated with lower extremity arteriosclerosis obliterans (LEASO) in a high-risk screening population to guide targeted primary prevention.</p><p><strong>Methods: </strong>This retrospective case-control study enrolled 300 individuals at high risk for LEASO from a tertiary hospital in Shanxi Province, China. Baseline lifestyle habits were assessed using the Lifestyle and Lower Extremity Vascular Health Questionnaire, and participants were followed for 2 years. Multivariate logistic regression was used to analyze the relationship between lifestyle habits and LEASO incidence.</p><p><strong>Results: </strong>Multivariate logistic regression identified smoking (OR = 2.289, 95% CI: 1.254-4.178), high-salt diet (OR = 2.040, 95% CI: 1.334-3.120), high-fat diet (OR = 1.988, 95% CI: 1.232-3.239), high-cholesterol diet (OR = 1.571, 95% CI: 1.131-2.183), staying up late (OR = 1.826, 95% CI: 1.119-2.980), and prolonged sitting (OR = 2.259, 95% CI: 1.034-4.937) as significant independent risk factors (all P < 0.05).</p><p><strong>Conclusion: </strong>In high-risk populations, specific lifestyle factors-particularly smoking, prolonged sitting, and poor dietary habits-are strongly associated with LEASO. These findings highlight the critical need for behavior-targeted community interventions to mitigate peripheral vascular disease progression.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"618865"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Differences in Medical Mistrust Among Patients with Non-Decompensated ALD and MetALD.","authors":"Elias D Rady, Hamza Dahshi, Ahmad Anouti, Courtney N Roberts, Mohammed Al-Hasan, Pojsakorn Danpanichkul, Jeremy Louissaint, Thomas A Kerr, Nicole E Rich, Amit G Singal, Mack C Mitchell, Thomas G Cotter","doi":"10.2147/RMHP.S602151","DOIUrl":"10.2147/RMHP.S602151","url":null,"abstract":"","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"602151"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing Risk Factors for Nosocomial COVID-19 Infection in a Taiwanese Hospital: An Integrated DEMATEL-ANP-IPA Approach.","authors":"Wei Hsu, I-Ting Yen","doi":"10.2147/RMHP.S628719","DOIUrl":"https://doi.org/10.2147/RMHP.S628719","url":null,"abstract":"<p><strong>Objective: </strong>During the COVID-19 pandemic, the rapid influx of patients with undiagnosed or confirmed infection increased the risk of healthcare-associated transmission and nosocomial infection. Identifying and prioritizing risk factors is essential for strengthening infection prevention and supporting hospital risk management and resource allocation. This exploratory study aimed to prioritize factors associated with nosocomial COVID-19 infection from an expert-based perspective.</p><p><strong>Methods: </strong>An integrated multicriteria decision-making (MCDM) framework combining the decision-making trial and evaluation laboratory (DEMATEL), analytic network process (ANP), and importance-performance analysis (IPA) was used to examine the relative importance, interrelationships, and intervention priorities of risk factors. Eight experts from five hospitals in Taiwan participated in the assessment. One hospital in Taipei City was selected as the case hospital for exploratory evaluation and prioritization.</p><p><strong>Results: </strong>\"Lack of hospital protective equipment\" and \"Superspreading event\" were identified as the most influential attributes, while \"Patients with high viral load\" and \"Close contact\" were the key risk factors associated with nosocomial COVID-19 infection. The integrated MCDM analysis also revealed interrelationships among risk factors and identified priorities of risk factors of infection-control intervention for the case hospital.</p><p><strong>Conclusion: </strong>The case hospital should prioritize adequate hospital facilities and infection risks associated with patients with chronic diseases when developing nosocomial infection prevention strategies. The proposed framework may support hospital risk assessment, infection-control planning, and resource allocation during infectious disease outbreaks. Given the exploratory and single-hospital design, the findings should be validated in other hospital settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"628719"},"PeriodicalIF":2.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Legal Indeterminacy to Risk-Governed Continuity: Operationalizing Risk Governance for China's Family Doctor Contract Services.","authors":"Yuan Lin, Yue Zhao","doi":"10.2147/RMHP.S647407","DOIUrl":"https://doi.org/10.2147/RMHP.S647407","url":null,"abstract":"<p><p>China's family doctor contract services (FDCS) are an important instrument for strengthening Primary Health Care, chronic disease management and continuity of care, but their legal and institutional foundations remain uneven. This Perspective treats legal indeterminacy not simply as a drafting defect but as a governable source of risk. It uses a structured narrative and legal-policy synthesis of Chinese FDCS policy and implementation materials and peer-reviewed studies principally from 2016-2025, relevant current Chinese laws and administrative rules, and limited functional reference points from the United Kingdom and Australia. The analysis distinguishes legal indeterminacy from regulatory fragmentation and implementation failure and develops an event-level qualitative risk-governance framework across five domains: contracting status and liability, rights, obligations and service packages, financing and evaluation, supervision and dispute resolution, and digital and data governance. Specific risk events are prioritized by qualitative likelihood and severity, with exposure and persistence recorded as potential escalation factors, and are then matched to proportionate regulatory responses. A worked example of remote diabetes follow-up illustrates the approach. The framework moves beyond catalogues of legal gaps by providing a transparent method for deciding where legal clarification and regulatory attention are most urgent, while remaining a conceptual tool that requires empirical validation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"647407"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Preparedness and Recurrent Shock Reduction in Somalia: The Roles of Adaptive Governance and Institutional Fragmentation.","authors":"Abdifatah Nour Rage","doi":"10.2147/RMHP.S629815","DOIUrl":"https://doi.org/10.2147/RMHP.S629815","url":null,"abstract":"<p><strong>Introduction: </strong>Somalia faces recurrent shocks including droughts, floods, conflict, and displacement that overwhelm governance systems and sustain reactive humanitarian responses. This quantitative cross-sectional study examines the associations between predictive preparedness, adaptive governance, institutional fragmentation, and recurrent shock reduction in Somalia, testing adaptive governance as a mediating mechanism and institutional fragmentation as a boundary condition.</p><p><strong>Methods: </strong>Survey data from 315 disaster professionals, government officials, humanitarian workers, and community leaders across Somalia's federal member states were analyzed using partial least squares structural equation modeling (PLS-SEM) with 5,000 bootstraps. Multi-item scales measured predictive preparedness, adaptive governance, institutional fragmentation, and recurrent shock reduction based on self-reported perceptions.</p><p><strong>Results: </strong>Predictive preparedness was positively associated with recurrent shock reduction (β = 0.28, p < 0.001) and adaptive governance (β = 0.42, p < 0.001). Adaptive governance partially mediated this relationship, with the indirect effect accounting for 35% of the total effect (indirect β = 0.15; 95% CI: 0.07, 0.23) and the direct effect accounting for the remaining 65% (β = 0.28; 95% CI: 0.16, 0.40). This partial mediation indicates that predictive preparedness operates through both governance-mediated and direct pathways. Institutional fragmentation significantly weakened the predictive preparedness-adaptive governance relationship (interaction β = -0.18, p < 0.001) and the adaptive governance-shock reduction relationship (interaction β = -0.22, p < 0.001). The conditional indirect effect was positive at low fragmentation (0.10, 95% CI: 0.04, 0.16, p < 0.001) but non-significant at high fragmentation (-0.10, 95% CI: -0.18, -0.02, p = 0.012). The model explained 48% of variance in shock reduction and 35% in adaptive governance.</p><p><strong>Discussion: </strong>Predictive preparedness is associated with recurrent shock reduction through both direct and governance-mediated pathways, with governance serving as a force multiplier rather than a prerequisite. Institutional fragmentation severely constrains these associations, fully attenuating the mediated pathway at high fragmentation levels. These findings suggest that preparedness investments should not be withheld pending governance reforms, as direct benefits may accrue even in fragmented contexts, but governance strengthening should proceed in parallel to amplify benefits. However, given the cross-sectional design and self-reported measures, all relationships should be interpreted as associations requiring longitudinal validation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"629815"},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and Future Applications of AI-Driven Predictive Modeling and a Proposed Framework for AI-Bioprognostics in Kidney Care.","authors":"Charat Thongprayoon, Noppawit Aiumtrakul, Francesco Pesce, Wisit Cheungpasitporn","doi":"10.2147/RMHP.S618968","DOIUrl":"https://doi.org/10.2147/RMHP.S618968","url":null,"abstract":"<p><p>Artificial intelligence (AI) is reshaping kidney care by integrating electronic health records (EHRs), imaging, digital pathology, genomics, wearable biosensors, and longitudinal physiologic data into dynamic risk-prediction systems. Traditional nephrology risk stratification has relied on static variables and regression-based models such as estimated glomerular filtration rate (eGFR), albuminuria, and composite clinical scores, which often inadequately capture nonlinear disease trajectories and phenotypic heterogeneity. Advances in machine learning, deep learning, and multimodal foundation models are accelerating the shift toward predictive, preventive, and precision nephrology. This narrative review evaluated AI applications across acute kidney injury (AKI), chronic kidney disease (CKD), dialysis, and transplantation. PubMed, Embase, Scopus, Web of Science, and IEEE Xplore were searched for English-language studies published from January 2015 through July 2026, prioritizing those reporting discrimination, calibration, external validation, or implementation outcomes. Across AKI, CKD, dialysis, and kidney transplantation, AI-based models have frequently demonstrated improved discrimination relative to conventional approaches, although the magnitude of improvement varies substantially across populations, prediction targets, comparators, and validation settings. In transplantation, multimodal systems integrating histopathology, donor-derived biomarkers, and clinical variables have improved prediction of rejection and graft failure. Emerging bioprognostic frameworks incorporating wearables, dialysis telemetry, and molecular biomarkers may support dynamic or near-real-time risk estimation of hyperkalemia, intradialytic hypotension, and cardiovascular instability. Prospective validation, assessment of calibration drift, and formal fairness analyses remain limited across the published literature, while dataset shift, restricted generalizability, algorithmic opacity, and workflow integration continue to constrain clinical adoption. AI-driven prediction and bioprognostics have the potential to support a transition from predominantly reactive kidney care toward more anticipatory and continuously informed precision care, although improved predictive performance has not yet been consistently shown to translate into improved patient outcomes. Realizing this potential will require rigorous external validation, prospective clinical-impact evaluation, equitable deployment, interoperable infrastructure, and human-in-the-loop oversight.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"618968"},"PeriodicalIF":2.6,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Shifts in Dietary Supplement Use Years After COVID-19: A Post-Pandemic Evaluation of Behaviors, Perceptions, and Predictors of Change in Jordan.","authors":"Esraa I Al-Trad, Mai Abdel Haleem Abusalah, Ayman Alsheikh, Adnan Salim Jaran, Yaqeen Abdelmajeed Rjoub, Rasha Ij'ear, Thana' Y ALjaraedah, Maram B Alhawarri","doi":"10.2147/RMHP.S637026","DOIUrl":"https://doi.org/10.2147/RMHP.S637026","url":null,"abstract":"<p><strong>Background: </strong>While numerous studies evaluated dietary supplement use during the acute phases of the COVID-19 pandemic, evidence regarding health behavioral changes remains scarce, particularly in the Middle East. This study provides a comprehensive evaluation of self-reported changes in dietary supplement consumption patterns before and years after the pandemic in Jordan, in a region where evidence on post-pandemic supplement use is limited.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Jordan (from June to August 2025) among 427 participants, with pre-pandemic dietary supplement use assessed retrospectively through participant self-report. Wilcoxon signed-rank test and McNemar's test were used for paired analyses. Multivariable ordinal logistic regression was applied to identify predictors of changes in use.</p><p><strong>Results: </strong>Significant increases in the use of most dietary supplements were observed in the post-pandemic era (<i>q</i> < 0.05), with the exception of herbal supplements. Nearly half of the participants (49.2%) reported a sustained increase in dietary supplement use. Daily consumption rose sharply from 6.6% pre-pandemic to 31.4%, while non-use declined from 16.2% to 11.0% (<i>p</i> < 0.001). The perceived importance of supplements for ongoing health maintenance surged, with \"very important\" responses rising from 17.3% to 59.5% (<i>p</i> < 0.001). Heightened health awareness was the most frequently reported reason for maintaining or increasing intake (71.0%). Multivariable ordinal logistic regression showed that baseline pre-pandemic supplement-use frequency, recruitment mode and COVID-19 infection severity were significantly associated with changes in supplement consumption.</p><p><strong>Conclusion: </strong>Changes in dietary supplement use in Jordan were observed after the pandemic, including a shift toward frequent and daily consumption. These findings suggest that changes in supplement-use behaviors remained evident in the post-pandemic period. The growing perceived value of dietary supplements underscores need for evidence-based public health guidance to promote safe and rational supplement use in the post-pandemic era.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"637026"},"PeriodicalIF":2.6,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Mini-Midline Catheters for Intravenous Antimicrobial Therapy Not Exceeding 14 Days: Treatment Completion Rate and Re-Catheterization Needs.","authors":"Lihong Liao, Jianfang Zhang, Liqin Li, Yuling Feng, Qiu Sun, Yiqing Shen, Xiaojing Ma, Chaoyi Dong, Lihua Shi","doi":"10.2147/RMHP.S620305","DOIUrl":"10.2147/RMHP.S620305","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether ultrasound-guided mini-midline catheter use (8-15 cm) is associated with treatment completion and safety outcomes compared with short peripheral catheters (<8 cm) for intravenous antimicrobial therapy lasting no more than 14 days, while additionally characterizing device specifications, peripheral drug compatibility, and cumulative vascular-access burden.</p><p><strong>Methods: </strong>This single-center retrospective comparative cohort study included 134 hospitalized adults (55 mini-midline, 79 short PIVC) receiving planned intravenous antimicrobial therapy for 5-14 days. The primary endpoint was treatment completion through the index device. Secondary outcomes included catheter-related complications, re-catheterization, cumulative catheter burden, inflammatory markers, and descriptively summarized dwell time among devices with documented insertion and removal timestamps.</p><p><strong>Results: </strong>Treatment completion was 46/51 (90.2%) for mini-midlines and 79/79 (100.0%) for short PIVCs (unadjusted p=0.005; absolute RD -9.8%; Holm-adjusted p=0.015). Among devices with documented timestamps, median dwell time was 310.0 hours (12.9 days) for mini-midlines and 71.5 hours (3.0 days) for short PIVCs. Complication rates were low, with 3/55 mini-midline patients experiencing 5 catheter-related events and 0/79 short-PIVC patients experiencing catheter-related events. No bloodstream infection or symptomatic thrombosis occurred in either group. Mini-midline patients required fewer total PIVCs per treatment episode, while cumulative insertion attempts were 61 and 85 in the mini-midline and short-PIVC groups, respectively. Diabetes mellitus and ≥2 puncture attempts were associated with treatment non-completion in the mini-midline group.</p><p><strong>Conclusion: </strong>Ultrasound-guided mini-midlines were associated with acceptable safety, longer observed peripheral dwell time, and reduced overall PIVC burden in selected hospitalized patients receiving up to 14 days of peripherally compatible intravenous antimicrobial therapy. Mini-midlines should be considered a complementary vascular-access strategy rather than a universal replacement for short PIVCs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"620305"},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimized Nursing Management for Ophthalmic Surgical Instruments: A Retrospective Study.","authors":"Liping Xia, Jin Yan, Xiaohua Guo, Sumei Bai, Yu Wang, Xiangli Gong","doi":"10.2147/RMHP.S625974","DOIUrl":"10.2147/RMHP.S625974","url":null,"abstract":"<p><strong>Purpose: </strong>To examine associations between an optimized nursing management model and instrument workflow, quality-related outcomes, and direct expenditure in ophthalmic surgery.</p><p><strong>Methods: </strong>This single-center retrospective study included 2422 procedures managed conventionally in 2022 (n = 1201) and under the optimized model in 2023 (n = 1221). The optimized model combined barcode-based traceability, standardized processing procedures, and periodic staff training. Adjusted analyses used regression models for continuous, ordinal, and binary outcomes and segmented interrupted time-series regression for monthly expenditure.</p><p><strong>Results: </strong>The optimized period was associated with shorter preparation time (adjusted mean difference, -1.533 min; 95% CI, -1.925 to -1.140; P < 0.001), higher timeliness scores (adjusted proportional OR, 1.430; 95% CI, 1.240-1.649; P < 0.001), and higher labeling clarity scores (adjusted proportional OR, 1.739; 95% CI, 1.505-2.009; P < 0.001). In exploratory analyses, packaging errors (adjusted RR, 0.592; 95% CI, 0.367-0.956; P = 0.032), surgical delays (adjusted RR, 0.737; 95% CI, 0.572-0.951; P = 0.019), and recorded instrument-related process events (adjusted RR, 0.442; 95% CI, 0.225-0.870; P = 0.018) were less frequent, whereas cleaning qualification was slightly higher (adjusted RR, 1.020; 95% CI, 1.001-1.039; P = 0.035). Interrupted time-series analysis showed an immediate reduction in monthly direct damage-related expenditure at the period transition (coefficient, -15,550.200 CNY; 95% CI, -26,116.910 to -4983.491; P = 0.006), with no clear slope change.</p><p><strong>Conclusion: </strong>The optimized nursing management model was associated with improved instrument workflow, lower recorded instrument damage burden, and lower direct damage-related expenditure. Damage and loss measures lacked use-based exposure denominators, and secular confounding cannot be excluded. Structured traceability may support organizational quality assurance and operational risk control, but effects on patient safety require direct evaluation in multicenter prospective studies.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"625974"},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semantic Mapping of Public Health Legislation and Emergency Legal Responses Using Natural Language Processing Techniques.","authors":"Dan Wang, Zhengbiao Guan, Bao Wu","doi":"10.2147/RMHP.S630169","DOIUrl":"10.2147/RMHP.S630169","url":null,"abstract":"<p><strong>Background: </strong>Public-health legislation is heterogeneous across jurisdictions, creating challenges for reproducible policy surveillance.</p><p><strong>Methods: </strong>Six publicly available policy-surveillance datasets from the LawAtlas Policy Surveillance Portal were consolidated and analyzed. After excluding records coded as \"No bills\" and collapsing repeated longitudinal snapshots within source domains, the data comprised 4328 snapshot rows, 2126 jurisdiction-by-bill source-domain records, and 1534 unique bills. Observed legal coverage extended from 6 August 2020 to 20 May 2022. Semantic mapping used TF-IDF, truncated singular-value decomposition, and K-Means clustering. Records containing at least 10 alphabetic tokens formed the semantic-mapping sample (n = 1875). Cluster number was selected using the maximum cosine silhouette coefficient across k = 2-12. Independent validation used the six curated LawAtlas source-domain memberships as multilabel targets for 821 unique bills; unsupervised cluster assignments were not used as supervised ground truth.</p><p><strong>Results: </strong>The maximum silhouette coefficient was 0.336 at k = 12, with five-seed stability yielding a mean pairwise adjusted Rand index of 0.718 (SD = 0.069). In the held-out validation set (n = 164), Logistic Regression achieved macro-F1 = 0.543 and micro-F1 = 0.752; five-fold cross-validation macro-F1 was 0.551 ± 0.039.</p><p><strong>Conclusion: </strong>The findings support transparent semantic mapping and source-domain classification of public-health-law surveillance records. Temporal findings are descriptive, and operational use requires human legal review and continuing performance monitoring.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"630169"},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}