Peering into the team role kaleidoscope: the interplay of personal characteristics and verbal interactions in collaborative problem solving.

The objective of this study is to explore the relationship between personality and peer-rated team role behavior on the one hand and team role behavior and verbal behavior on the other hand. To achieve this, different data types were collected in fifteen professional teams of four members (N = 60) from various private and public organizations in Flanders, Belgium. Participants' personalities were assessed using a workplace-contextualized personality questionnaire based on the Big Five, including domains and facets. Typical team role behavior was assessed by the team members using the Team Role Experience and Orientation peer rating system. Verbal interactions of nine of the teams (n = 36) were recorded in an educational lab setting, where participants performed several collaborative problem-solving tasks as part of a training. To process these audio data, a coding scheme for collaborative problem solving and linguistic inquiry and word count were used. We identified robust links and logical correlation patterns between personality traits and typical team role behaviors, complementing prior research that only focused on self-reported team behavior. For instance, a relatively strong correlation was found between Altruism and the Team builder role. Next, the study reveals that role taking within teams is associated with specific verbal interaction patterns. For example, members identified as Organizers were more engaged in responding to others' ideas and monitoring execution.

Big Data in Epidemiology: Brave New World?

Epidemiology is experiencing a significant shift toward the utilization of big data for health monitoring and decision-making. This article discusses the recent example of the World Health Organization (WHO) global oral health status report and regional summaries, which faced criticisms due to its reliance on big data from the Global Burden of Disease (GBD) study. We address the arguments for and against the use of big data in epidemiology and provide an assessment of the value and limitations of big data epidemiology. Moreover, we provide recommendations as to how the oral health community should reconcile traditional epidemiologic approaches with big data and advanced data analytics. This Perspective article highlights the challenges of the current epidemiologic landscape, the potential of big data, and the need for a balanced approach to data utilization in epidemiology.

The current state of inflammation-related research in prostate cancer: a bibliometric analysis and systematic review.

Background: Prostate cancer (PCa) is the second most prevalent malignancy among men globally. The diagnosis, treatment, and prognosis of prostate cancer frequently fall short of expectations. In recent years, the connection between inflammation and prostate cancer has attracted considerable attention. However, there is a lack of bibliometric studies analyzing the research on inflammation within the domain of prostate cancer. Research methods: We utilized the Web of Science Core Collection (WOSCC) as our data source to extract articles and reviews related to inflammation in prostate cancer, published up until April 12, 2024. The collected data underwent meticulous manual screening, followed by bibliometric analysis and visualization using the Biblioshiny package in R. Results: This study encompasses an analysis of 2,786 papers focusing on inflammation-related research within the realm of prostate cancer. Recent years have seen a significant proliferation of publications in this area, with the United States and China being the foremost contributors. The most prolific author in this domain is Demarzoam, with Johns Hopkins University standing out as the most influential institution. The leading journal in disseminating these studies is PROSTATE. Keyword co-occurrence analysis reveals that 'inflammation-related biomarkers', 'inflammation index', and 'tumor immune microenvironment' represent the current research hotspots and frontiers. Conclusion: The findings of this bibliometric study serve to illuminate the current landscape of inflammation-related research in the field of prostate cancer, while further augmenting the discourse on inflammation-mediated cancer therapeutics. Of particular note is the potential of these discoveries to facilitate a more nuanced understanding among researchers regarding the interplay between inflammation and prostate cancer.

What influences the use of HR analytics in Human Resource management in Norwegian municipal health care services?

BACKGROUND: The centrality of human resources in the provision of healthcare suggests that Human Resource (HR) management and the use of Human Resource analytics - use of digital data to better understand, assess, plan and organize the workforce - can play an important role in this. However, data driven decision making in the field of human resource management is lagging, and the appropriation of HR analytics in the healthcare sector is limited. AIM: The current study explores the role of HR departments and the adoption of Human Resource analytics in four municipalities in Norway to obtain insights into what influences the use or lack of use of HR analytics. METHODS: Empirical data were generated through qualitative interviews with fourteen individuals working in HR departments, the municipal administration, and the healthcare services. Structurational theory guided the analysis. The findings show that none of the municipalities made extensive use of data to inform decision making related to human resource management or workforce planning. RESULTS AND CONCLUSION: Three conditions hampered or made irrelevant the use of HR analytics: a decoupling between the services and HR, a weak data-culture, and HR and decision-making processes involving a plurality of stakeholders. However, there were changes underway in all municipalities related to the role of HR and HR analytics.

Regulatory Challenges and Frameworks for Fog Computing in Healthcare.

The integration of fog computing into healthcare promises significant advancements in real-time data analytics and patient care by decentralizing data processing closer to the source. This shift, however, introduces complex regulatory, privacy, and security challenges that are not adequately addressed by existing frameworks designed for centralized systems. The distributed nature of fog computing complicates the uniform application of security measures and compliance with diverse international regulations, raising concerns about data privacy, security vulnerabilities, and legal accountability. This review explores these challenges in depth, discussing the implications of fog computing's decentralized architecture for data privacy, the difficulties in achieving consistent security across dispersed nodes, and the complexities of ensuring compliance in multi-jurisdictional environments. It also examines specific regulatory frameworks, including Health Insurance Portability and Accountability (HIPAA) in the United States, General Data Protection Regulation (GDPR) in the European Union, and emerging laws in Asia and Brazil, highlighting the gaps and the need for regulatory evolution to better accommodate the nuances of fog computing. The review advocates for a proactive regulatory approach, emphasizing the development of specific guidelines, international collaboration, and public-private partnerships to enhance compliance and support innovation. By embedding privacy and security by design and leveraging advanced technologies, healthcare providers can navigate the regulatory landscape effectively, ensuring that fog computing realizes its full potential as a transformative healthcare technology without compromising patient trust or data integrity.

OnetoMap Meta-Data: Healthcare Analytics Through Research.

INTRODUCTION: Big Data has revolutionized healthcare research through the three Vs: volume, veracity, and variety. This study introduces the OnetoMap meta-data repository, a centralized inventory developed in collaboration with the University of South Florida's Department of Surgery. METHODS: The repository offers extensive details about each database, including its primary purpose, available variables, and examples of high-impact research utilizing these databases. It aims to create a centralized inventory, enabling researchers to locate and link relevant datasets efficiently. Each dataset is described using standardized criteria to ensure clarity and usability, such as data type, source, collection methods, and potential linkages to other datasets.  Results: Currently, the OnetoMap repository contains descriptions of 49 datasets, with ongoing updates to include new datasets and additional data years. These datasets include a range of data types, including cross-sectional and longitudinal, gathered through claims, registries, electronic health records, and surveys. The repository is hosted on GitHub, enabling version control, collaboration, and open access. Effective search functionalities and descriptive categorization enhance the findability of datasets. DISCUSSION: The data repository includes comprehensive records of patient health statuses, socioeconomic profiles, hospital structures, and physician practices, enabling nuanced interventions and addressing complex healthcare needs. It also promotes interdisciplinary research and accelerates novel discoveries by providing a centralized source of diverse data and facilitating collaboration among research teams. CONCLUSION: The OnetoMap meta-data repository represents a significant advancement in healthcare research by providing a centralized, detailed, and easily accessible repository of clinical research databases. Future directions include implementing automatic annual updates of datasets, exploring automatic dataset linkage, providing monthly updates on published research, creating a user chat space for enhanced collaboration, and developing code applets for simplified data analysis. These efforts will ensure that the repository remains current, functional, and accessible, ultimately facilitating new discoveries and insights in healthcare outcomes research.

Advanced technology in shoulder arthroplasty surgery: Artificial intelligence, extended reality, and robotics.

The purpose of this review is to provide an overview of the integration of technological advancements in orthopedic shoulder surgery. Recent technological advancements in orthopedic shoulder surgery include predictive analytics, computer-navigated instrumentation for operative planning, extended reality, and robotics. Separately, these advancements provide distinct methodological attempts to improve surgical experiences and outcomes. Together, these technologies can provide orthopedic surgeons with the tools and capabilities to improve patient care and communication in shoulder arthroplasty. From artificial intelligence-generated predictive analytics to extended reality and robotics, technical innovations may lead to improvements in patient education, surgical accuracy, interdisciplinary communication, and outcomes. A comprehensive narrative review was conducted to explore the technological advancements of orthopedic shoulder arthroplasty. Our findings emphasized the impact of these advancements, exemplified by early enhancements in efficacy and safety. However, certain challenges remain, such as a lack of reproducibly improved outcomes and cost considerations. While the reviewed studies indicate hope for improving shoulder arthroplasty, the true cost-effectiveness and applicability remains to be determined, indicating the need for further research.

Integrating Social Determinants of Health in Machine Learning-Driven Decision Support for Diabetes Case Management: Protocol for a Sequential Mixed Methods Study.

BACKGROUND: The use of both clinical factors and social determinants of health (SDoH) in referral decision-making for case management may improve optimal use of resources and reduce outcome disparities among patients with diabetes. OBJECTIVE: This study proposes the development of a data-driven decision-support system incorporating interactions between clinical factors and SDoH into an algorithm for prioritizing who receives case management services. The paper presents a design for prediction validation and preimplementation assessment that uses a mixed methods approach to guide the implementation of the system. METHODS: Our study setting is a large, tertiary care academic medical center in the Deep South of the United States, where SDoH contribute to disparities in diabetes-specific hospitalizations and emergency department (ED) visits. This project will develop an interpretable artificial intelligence model for a population with diabetes using SDoH and clinical data to identify which posthospitalization cases have a higher likelihood of subsequent ED use. The electronic health record data collected for the study include demographics, SDoH, comorbidities, hospitalization-related factors, laboratory test results, and medication use to predict posthospitalization ED visits. Subsequently, a mixed methods approach will be used to validate prediction outcomes and develop an implementation strategy from insights into patient outcomes from case managers, clinicians, and quality and patient safety experts. RESULTS: As of December 2023, we had abstracted data on 174,871 inpatient encounters between January 2018 and September 2023, involving 89,355 unique inpatients meeting inclusion criteria. Both clinical and SDoH data items were included for these patient encounters. In total, 85% of the inpatient visits (N=148,640) will be used for training (learning from the data) and the remaining 26,231 inpatient visits will be used for mixed-methods validation (testing). CONCLUSIONS: By integrating a critical suite of SDoH with clinical data related to diabetes, the proposed data-driven risk stratification model can enable individualized risk estimation and inform health professionals (eg, case managers) about the risk of patients' upcoming ED use. The prediction outcome could potentially automate case management referrals, helping to better prioritize services. By taking a mixed methods approach, we aim to align the model with the hospital's specific quality and patient safety considerations for the quality of patient care and the optimization of case management resource allocation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56049.

Investigating Acoustic and Psycholinguistic Predictors of Cognitive Impairment in Older Adults: Modeling Study.

BACKGROUND: About one-third of older adults aged 65 years and older often have mild cognitive impairment or dementia. Acoustic and psycho-linguistic features derived from conversation may be of great diagnostic value because speech involves verbal memory and cognitive and neuromuscular processes. The relative decline in these processes, however, may not be linear and remains understudied. OBJECTIVE: This study aims to establish associations between cognitive abilities and various attributes of speech and natural language production. To date, the majority of research has been cross-sectional, relying mostly on data from structured interactions and restricted to textual versus acoustic analyses. METHODS: In a sample of 71 older (mean age 83.3, SD 7.0 years) community-dwelling adults who completed qualitative interviews and cognitive testing, we investigated the performance of both acoustic and psycholinguistic features associated with cognitive deficits contemporaneously and at a 1-2 years follow up (mean follow-up time 512.3, SD 84.5 days). RESULTS: Combined acoustic and psycholinguistic features achieved high performance (F1-scores 0.73-0.86) and sensitivity (up to 0.90) in estimating cognitive deficits across multiple domains. Performance remained high when acoustic and psycholinguistic features were used to predict follow-up cognitive performance. The psycholinguistic features that were most successful at classifying high cognitive impairment reflected vocabulary richness, the quantity of speech produced, and the fragmentation of speech, whereas the analogous top-ranked acoustic features reflected breathing and nonverbal vocalizations such as giggles or laughter. CONCLUSIONS: These results suggest that both acoustic and psycholinguistic features extracted from qualitative interviews may be reliable markers of cognitive deficits in late life.

Redefining Spectral Data Analysis with Immersive Analytics: Exploring Domain-Shifted Model Spaces for Optimal Model Selection.

Modern developments in autonomous chemometric machine learning technology strive to relinquish the need for human intervention. However, such algorithms developed and used in chemometric multivariate calibration and classification applications exclude crucial expert insight when difficult and safety-critical analysis situations arise, e.g., spectral-based medical decisions such as noninvasively determining if a biopsy is cancerous. The prediction accuracy and interpolation capabilities of autonomous methods for new samples depend on the quality and scope of their training (calibration) data. Specifically, analysis patterns within target data not captured by the training data will produce undesirable outcomes. Alternatively, using an immersive analytic approach allows insertion of human expert judgment at key machine learning algorithm junctures forming a sensemaking process performed in cooperation with a computer. The capacity of immersive virtual reality (IVR) environments to render human comprehensible three-dimensional space simulating real-world encounters, suggests its suitability as a hybrid immersive human-computer interface for data analysis tasks. Using IVR maximizes human senses to capitalize on our instinctual perception of the physical environment, thereby leveraging our innate ability to recognize patterns and visualize thresholds crucial to reducing erroneous outcomes. In this first use of IVR as an immersive analytic tool for spectral data, we examine an integrated IVR real-time model selection algorithm for a recent model updating method that adapts a model from the original calibration domain to predict samples from shifted target domains. Using near-infrared data, analyte prediction errors from IVR-selected models are reduced compared to errors using an established autonomous model selection approach. Results demonstrate the viability of IVR as a human data analysis interface for spectral data analysis including classification problems.

Impact of a Digital Scribe System on Clinical Documentation Time and Quality: Usability Study.

BACKGROUND: Physicians spend approximately half of their time on administrative tasks, which is one of the leading causes of physician burnout and decreased work satisfaction. The implementation of natural language processing-assisted clinical documentation tools may provide a solution. OBJECTIVE: This study investigates the impact of a commercially available Dutch digital scribe system on clinical documentation efficiency and quality. METHODS: Medical students with experience in clinical practice and documentation (n=22) created a total of 430 summaries of mock consultations and recorded the time they spent on this task. The consultations were summarized using 3 methods: manual summaries, fully automated summaries, and automated summaries with manual editing. We then randomly reassigned the summaries and evaluated their quality using a modified version of the Physician Documentation Quality Instrument (PDQI-9). We compared the differences between the 3 methods in descriptive statistics, quantitative text metrics (word count and lexical diversity), the PDQI-9, Recall-Oriented Understudy for Gisting Evaluation scores, and BERTScore. RESULTS: The median time for manual summarization was 202 seconds against 186 seconds for editing an automatic summary. Without editing, the automatic summaries attained a poorer PDQI-9 score than manual summaries (median PDQI-9 score 25 vs 31, P<.001, ANOVA test). Automatic summaries were found to have higher word counts but lower lexical diversity than manual summaries (P<.001, independent t test). The study revealed variable impacts on PDQI-9 scores and summarization time across individuals. Generally, students viewed the digital scribe system as a potentially useful tool, noting its ease of use and time-saving potential, though some criticized the summaries for their greater length and rigid structure. CONCLUSIONS: This study highlights the potential of digital scribes in improving clinical documentation processes by offering a first summary draft for physicians to edit, thereby reducing documentation time without compromising the quality of patient records. Furthermore, digital scribes may be more beneficial to some physicians than to others and could play a role in improving the reusability of clinical documentation. Future studies should focus on the impact and quality of such a system when used by physicians in clinical practice.

Facile Determination of Aluminum Content in Industrial Brine by Investigating the Effects of Buffer Systems.

The aluminum content of concentrated (27 wt%) sodium chloride solutions could be crucial for large-scale chlor-alkali-based industries applying membrane cell electrolysis. Thus, a facile method which enables a fast and reliable protocol to determine the Al content of these solutions on ppb scale in industrial environments is fundamentally important. It was demonstrated that the increased sensitivity of colorful Al-ECR (eriochrome cyanine R) complex by the use of a cationic surfactant and specific biological buffers could effectively indicate the Al content in an extended pH interval of a concentrated saline medium under industrial conditions. The dependence of the analytical protocol on pH, temperature, time, wavelength, and the salinity of the medium was investigated. It was shown that the absorbance-based measurements of the solution should be performed at least 2-4 h after its preparation. By applying the selected two Good's buffers (HEPES: 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid, MOPS: 3-(N-morpholino)-propanesulfonic acid) and Tris (tris(hydroxymethyl)aminomethane), 32.8-38.1 % increase in the sensitivity was achieved for saturated NaCl solutions. Moreover, the limits of detection and quantification (LOD, LOQ) were also lowered by 19.0-29.8 %, and the salinity dependence of the calibration was also reduced.

Selection of data analytic techniques by using fuzzy AHP TOPSIS from a healthcare perspective.

The healthcare industry has been put to test the need to manage enormous amounts of data provided by various sources, which are renowned for providing enormous quantities of heterogeneous information. The data are collected and analyzed with different Data Analytic (DA) and machine learning algorithm approaches. Researchers, scientists, and industrialists must manage or select the best approach associated with DA in healthcare. This scientific study is based on decision analysis between the DA factors and alternatives. The information affects the whole system in a rational manner. This information is very important in healthcare sector for appropriate prediction and analysis. The evaluation discusses its benefits and presents an analytic framework. The Fuzzy Analytic Hierarchy Process (Fuzzy AHP) approach is used to address the weight of the factors. The Fuzzy Techniques for Order Preference by Similarity to Ideal Solution (Fuzzy TOPSIS) address the rank of the data analytic alternatives used in healthcare sector. The models used in the article briefly discuss the challenges of DA and approaches to address those challenges. The assorted factors of DA are capture, cleaning, storage, security, stewardship, reporting, visualization, updating, sharing, and querying. The DA alternatives include descriptive, diagnostic, predictive, prescriptive, discovery, regression, cohort and inferential analyses. The most influential factors of the DA and the most suitable approach for the DA are evaluated. The 'cleaning' factor has the highest weight, and 'updating' is achieved at least by the Fuzzy-AHP approach. The regression approach of data analysis had the highest rank, and the diagnostic analysis had the lowest rank. Decision analyses are necessary for data scientists and medical providers to predict diseases appropriately in the healthcare domain. This analysis also revealed the cost benefits to hospitals.

Exploring artificial intelligence techniques to research low energy nuclear reactions.

The world urgently needs new sources of clean energy due to a growing global population, rising energy use, and the effects of climate change. Nuclear energy is one of the most promising solutions for meeting the world's energy needs now and in the future. One type of nuclear energy, Low Energy Nuclear Reactions (LENR), has gained interest as a potential clean energy source. Recent AI advancements create new ways to help research LENR and to comprehensively analyze the relationships between experimental parameters, materials, and outcomes across diverse LENR research endeavors worldwide. This study explores and investigates the effectiveness of modern AI capabilities leveraging embedding models and topic modeling techniques, including Latent Dirichlet Allocation (LDA), BERTopic, and Top2Vec, in elucidating the underlying structure and prevalent themes within a large LENR research corpus. These methodologies offer unique perspectives on understanding relationships and trends within the LENR research landscape, thereby facilitating advancements in this crucial energy research area. Furthermore, the study presents LENRsim, an experimental machine learning tool to identify similar LENR studies, along with a user-friendly web interface for widespread adoption and utilization. The findings contribute to the understanding and progression of LENR research through data-driven analysis and tool development, enabling more informed decision-making and strategic planning for future research in this field. The insights derived from this study, along with the experimental tools we developed and deployed, hold the potential to significantly aid researchers in advancing their studies of LENR.

In-hospital mortality, readmission, and prolonged length of stay risk prediction leveraging historical electronic patient records.

Objective: This study aimed to investigate the predictive capabilities of historical patient records to predict patient adverse outcomes such as mortality, readmission, and prolonged length of stay (PLOS). Methods: Leveraging a de-identified dataset from a tertiary care university hospital, we developed an eXplainable Artificial Intelligence (XAI) framework combining tree-based and traditional machine learning (ML) models with interpretations and statistical analysis of predictors of mortality, readmission, and PLOS. Results: Our framework demonstrated exceptional predictive performance with a notable area under the receiver operating characteristic (AUROC) of 0.9625 and an area under the precision-recall curve (AUPRC) of 0.8575 for 30-day mortality at discharge and an AUROC of 0.9545 and AUPRC of 0.8419 at admission. For the readmission and PLOS risk, the highest AUROC achieved were 0.8198 and 0.9797, respectively. The tree-based models consistently outperformed the traditional ML models in all 4 prediction tasks. The key predictors were age, derived temporal features, routine laboratory tests, and diagnostic and procedural codes. Conclusion: The study underscores the potential of leveraging medical history for enhanced hospital predictive analytics. We present an accurate and intuitive framework for early warning models that can be easily implemented in the current and developing digital health platforms to predict adverse outcomes accurately.

A Predictive Quality Inspection Framework for the Manufacturing Process in the Context of Industry 4.0.

The purpose of this research is to develop an innovative software framework with AI capabilities to predict the quality of automobiles at the end of the production line. By utilizing machine learning techniques, this framework aims to prevent defective vehicles from reaching customers, thus enhancing production efficiency, reducing costs, and shortening the manufacturing time of automobiles. The principal results demonstrate that the predictive quality inspection framework significantly improves defect detection and supports personalized road tests. The major conclusions indicate that integrating AI into quality control processes offers a sustainable, long-term solution for continuous improvement in automotive manufacturing, ultimately increasing overall production efficiency. The economic benefit of our solution is significant. Currently, a final test drive takes 10-30 min, depending on the car model. If 200,000-300,000 cars are produced annually and our data prediction of quality saves 10 percent of test drives with test drivers, this represents a minimum annual saving of 200,000 production minutes.

Multidimensional-Based Prediction of Pressure Ulcers Development and Severity in Hospitalized Frail Oldest Old: A Retrospective Study.

Purpose: In recent times, growing uncertainty has emerged regarding the effectiveness of standard pressure ulcer (PU) risk assessment tools, which are suspected to be no better than clinical judgment, especially in the frail and comorbid elderly population. This study aimed to identify the primary clinical predictive variables for PU development and severity in hospitalized older adults, utilizing a multidimensional frailty assessment, and compare them with the Braden scale. Patients and methods: The population consisted of 316 patients, admitted to the Geriatric Unit and Transitional Care of San Bartolomeo Hospital in Sarzana (Italy) during the period 21/02/22-01/07/22. The collected information included both anamnestic and laboratory data. A comprehensive geriatric assessment was performed, including also anthropometric and physical performance measurements. Multivariate logistic analysis was used, both in a binary classification test and in the subsequent ordinal classification test of severity levels. The final performance of the model was assessed by ROC curve estimation and AUC comparison with the Braden scale. Results: Within the population, 152 subjects (48%) developed PU at different levels of severity. The results showed that age, Braden scale (subscales of mobility and friction/shear), Barthel scale, Mini Nutritional Assessment, hemoglobin, and albumin are predictors associated with the development of PU (AUC 85%). The result is an improvement over the use of the Braden scale alone (AUC 75%). Regarding the identification of predictive factors for PU severity, 4AT also emerges as potentially relevant. Conclusion: Assessing the subject's nutritional status, physical performance, and functional autonomies enables the effective integration of the Braden scale in identifying patients most susceptible to developing PU. Our findings support the integration of a comprehensive set of methodologically robust frailty determinants into traditional risk assessment tools. This integration reflects the mutual interplay between patients' frailty, skin frailty, and PU development in very old hospitalized patients.

Utilisation of Learning Analytics to Identify Students at Risk of Poor Academic Performance in Medical Schools.

Introduction Identifying students at risk of failure before they experience difficulties may considerably improve their outcomes. However, identification techniques can be costly, time-intensive, and of unknown efficacy. Medical educators need accessible and cost-effective ways of identifying at-risk students. The aim of this study was to investigate the relationship between student engagement in an online classroom and academic performance given the transition of many courses from in-person to online learning.  Methods A retrospective study was conducted on a group of 235 students from the University of Edinburgh Bachelor of Medicine and Surgery (MBChB) in Year One for eight weeks from the start of term, September 2020. Purposive sampling was used. Data were collected on total test submissions, total discussion board submissions, engagement scores, and overall exam scores. Learning analytics on discussion board engagement were collected for new medical students before they had sat any summative assessment. Tests completed, discussion board posts made, and their total engagement score were correlated with their first summative assessment scores at the end of semester one. Results We found a statistically significant correlation between total test submissions, total discussion board submissions, engagement scores, and overall exam scores, with small-medium effects (r = 0.281, p<0.001) (r = 0.241, p<0.001), and (r = 0.202, p<0.001). Students with more test submissions, total discussion board submissions, and total engagement had a higher overall exam score. There was a statistically significant moderate correlation between total submissions and overall exam scores (r = 0.324, p<0.001). Conclusions Students who had a higher number of submissions were more likely to perform better on assessments. Early engagement correlates with performance. Learning analytics can help identify student underperformance before they undertake any assessment, and this can be done very inexpensively and with minimal staff resources if properly planned.