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Journal of the American Medical Informatics Association: JAMIA

Chandler McClellan, Mir M Ali, Ryan Mutter, Larry Kroutil, Justin Landwehr
OBJECTIVES: Given the public health importance of communicating about mental illness and the growing use of social media to convey information, our goal was to develop an empirical model to identify periods of heightened interest in mental health topics on Twitter. MATERIALS AND METHODS: We collected data on 176 million tweets from 2011 to 2014 with content related to depression or suicide. Using an autoregressive integrated moving average (ARIMA) data analysis, we identified deviations from predicted trends in communication about depression and suicide...
October 5, 2016: Journal of the American Medical Informatics Association: JAMIA
Aizhan Tursunbayeva, Raluca Bunduchi, Massimo Franco, Claudia Pagliari
OBJECTIVE: This systematic review aimed to: (1) determine the prevalence and scope of existing research on human resource information systems (HRIS) in health organizations; (2) analyze, classify, and synthesize evidence on the processes and impacts of HRIS development, implementation, and adoption; and (3) generate recommendations for HRIS research, practice, and policy, with reference to the needs of different stakeholders. METHODS: A structured search strategy was used to interrogate 10 electronic databases indexing research from the health, social, management, technology, and interdisciplinary sciences, alongside gray literature sources and reference lists of qualifying studies...
October 5, 2016: Journal of the American Medical Informatics Association: JAMIA
Mike Wu, Marzyeh Ghassemi, Mengling Feng, Leo A Celi, Peter Szolovits, Finale Doshi-Velez
BACKGROUND: The widespread adoption of electronic health records allows us to ask evidence-based questions about the need for and benefits of specific clinical interventions in critical-care settings across large populations. OBJECTIVE: We investigated the prediction of vasopressor administration and weaning in the intensive care unit. Vasopressors are commonly used to control hypotension, and changes in timing and dosage can have a large impact on patient outcomes...
October 5, 2016: Journal of the American Medical Informatics Association: JAMIA
Ahmed Allam, Peter J Schulz, Michael Krauthammer
BACKGROUND: As the Internet becomes the number one destination for obtaining health-related information, there is an increasing need to identify health Web pages that convey an accurate and current view of medical knowledge. In response, the research community has created multicriteria instruments for reliably assessing online medical information quality. One such instrument is DISCERN, which measures health Web page quality by assessing an array of features. In order to scale up use of the instrument, there is interest in automating the quality evaluation process by building machine learning (ML)-based DISCERN Web page classifiers...
October 5, 2016: Journal of the American Medical Informatics Association: JAMIA
Chi Yan Hui, Robert Walton, Brian McKinstry, Tracy Jackson, Richard Parker, Hilary Pinnock
OBJECTIVES: Telehealth is promoted as a strategy to support self-management of long-term conditions. The aim of this systematic review is to identify which information and communication technology features implemented in mobile apps to support asthma self-management are associated with adoption, adherence to usage, and clinical effectiveness. METHODS: We systematically searched 9 databases, scanned reference lists, and undertook manual searches (January 2000 to April 2016)...
October 2, 2016: Journal of the American Medical Informatics Association: JAMIA
Alexandre Caron, Emmanuel Chazard, Joris Muller, Renaud Perichon, Laurie Ferret, Vassilis Koutkias, Régis Beuscart, Jean-Baptiste Beuscart, Grégoire Ficheur
BACKGROUND: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety. OBJECTIVE: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases...
September 27, 2016: Journal of the American Medical Informatics Association: JAMIA
Adam S Brown, Chirag J Patel
OBJECTIVE: Drug repositioning is a promising methodology for reducing the cost and duration of the drug discovery pipeline. We sought to develop a computational repositioning method leveraging annotations in the literature, such as Medical Subject Heading (MeSH) terms. METHODS: We developed software to determine significantly co-occurring drug-MeSH term pairs and a method to estimate pair-wise literature-derived distances between drugs. RESULTS: We found that literature-based drug-drug similarities predicted the number of shared indications across drug-drug pairs...
September 27, 2016: Journal of the American Medical Informatics Association: JAMIA
Mary G Amato, Alejandra Salazar, Thu-Trang T Hickman, Arbor Jl Quist, Lynn A Volk, Adam Wright, Dustin McEvoy, William L Galanter, Ross Koppel, Beverly Loudin, Jason Adelman, John D McGreevey, David H Smith, David W Bates, Gordon D Schiff
OBJECTIVE: To examine medication errors potentially related to computerized prescriber order entry (CPOE) and refine a previously published taxonomy to classify them. MATERIALS AND METHODS: We reviewed all patient safety medication reports that occurred in the medication ordering phase from 6 sites participating in a United States Food and Drug Administration-sponsored project examining CPOE safety. Two pharmacists independently reviewed each report to confirm whether the error occurred in the ordering/prescribing phase and was related to CPOE...
September 27, 2016: Journal of the American Medical Informatics Association: JAMIA
Jonathan H Chen, Mary K Goldstein, Steven M Asch, Lester Mackey, Russ B Altman
OBJECTIVE: Build probabilistic topic model representations of hospital admissions processes and compare the ability of such models to predict clinical order patterns as compared to preconstructed order sets. MATERIALS AND METHODS: The authors evaluated the first 24 hours of structured electronic health record data for > 10 K inpatients. Drawing an analogy between structured items (e.g., clinical orders) to words in a text document, the authors performed latent Dirichlet allocation probabilistic topic modeling...
September 20, 2016: Journal of the American Medical Informatics Association: JAMIA
Juan D Chaparro, David C Classen, Melissa Danforth, David C Stockwell, Christopher A Longhurst
OBJECTIVE: To evaluate the safety of computerized physician order entry (CPOE) and associated clinical decision support (CDS) systems in electronic health record (EHR) systems at pediatric inpatient facilities in the US using the Leapfrog Group's pediatric CPOE evaluation tool. METHODS: The Leapfrog pediatric CPOE evaluation tool, a previously validated tool to assess the ability of a CPOE system to identify orders that could potentially lead to patient harm, was used to evaluate 41 pediatric hospitals over a 2-year period...
September 16, 2016: Journal of the American Medical Informatics Association: JAMIA
Pamala A Pawloski, Avis J Thomas, Sheryl Kane, Gabriela Vazquez-Benitez, Gary R Shapiro, Gary H Lyman
OBJECTIVES: Clinical guidelines recommending the use of myeloid growth factors are largely based on the prescribed chemotherapy regimen. The guidelines suggest that oncologists consider patient-specific characteristics when prescribing granulocyte-colony stimulating factor (G-CSF) prophylaxis; however, a mechanism to quantify individual patient risk is lacking. Readily available electronic health record (EHR) data can provide patient-specific information needed for individualized neutropenia risk estimation...
September 16, 2016: Journal of the American Medical Informatics Association: JAMIA
Sheng Yu, Abhishek Chakrabortty, Katherine P Liao, Tianrun Cai, Ashwin N Ananthakrishnan, Vivian S Gainer, Susanne E Churchill, Peter Szolovits, Shawn N Murphy, Isaac S Kohane, Tianxi Cai
OBJECTIVE: Phenotyping algorithms are capable of accurately identifying patients with specific phenotypes from within electronic medical records systems. However, developing phenotyping algorithms in a scalable way remains a challenge due to the extensive human resources required. This paper introduces a high-throughput unsupervised feature selection method, which improves the robustness and scalability of electronic medical record phenotyping without compromising its accuracy. METHODS: The proposed Surrogate-Assisted Feature Extraction (SAFE) method selects candidate features from a pool of comprehensive medical concepts found in publicly available knowledge sources...
September 15, 2016: Journal of the American Medical Informatics Association: JAMIA
Susan E Spratt, Katherine Pereira, Bradi B Granger, Bryan C Batch, Matthew Phelan, Michael Pencina, Marie Lynn Miranda, Ebony Boulware, Joseph E Lucas, Charlotte L Nelson, Benjamin Neely, Benjamin A Goldstein, Pamela Barth, Rachel L Richesson, Isaretta L Riley, Leonor Corsino, Eugenia R McPeek Hinz, Shelley Rusincovitch, Jennifer Green, Anna Beth Barton, Carly Kelley, Kristen Hyland, Monica Tang, Amanda Elliott, Ewa Ruel, Alexander Clark, Melanie Mabrey, Kay Lyn Morrissey, Jyothi Rao, Beatrice Hong, Marjorie Pierre-Louis, Katherine Kelly, Nicole Jelesoff
OBJECTIVE: We assessed the sensitivity and specificity of 8 electronic health record (EHR)-based phenotypes for diabetes mellitus against gold-standard American Diabetes Association (ADA) diagnostic criteria via chart review by clinical experts. MATERIALS AND METHODS: We identified EHR-based diabetes phenotype definitions that were developed for various purposes by a variety of users, including academic medical centers, Medicare, the New York City Health Department, and pharmacy benefit managers...
September 11, 2016: Journal of the American Medical Informatics Association: JAMIA
Jennifer L Guthrie, David C Alexander, Alex Marchand-Austin, Karen Lam, Michael Whelan, Brenda Lee, Colin Furness, Elizabeth Rea, Rebecca Stuart, Julia Lechner, Monali Varia, Jennifer McLean, Frances B Jamieson
OBJECTIVE: Develop a tool to disseminate integrated laboratory, clinical, and demographic case data necessary for improved contact tracing and outbreak detection of tuberculosis (TB). METHODS: In 2007, the Public Health Ontario Laboratories implemented a universal genotyping program to monitor the spread of TB strains within Ontario. Ontario Universal Typing of TB (OUT-TB) Web utilizes geographic information system (GIS) technology with a relational database platform, allowing TB control staff to visualize genotyping matches and microbiological data within the context of relevant epidemiological and demographic data...
September 2, 2016: Journal of the American Medical Informatics Association: JAMIA
Hyeoneui Kim, Elizabeth Bell, Jihoon Kim, Amy Sitapati, Joe Ramsdell, Claudiu Farcas, Dexter Friedman, Stephanie Feudjio Feupe, Lucila Ohno-Machado
BACKGROUND: Implementation of patient preferences for use of electronic health records for research has been traditionally limited to identifiable data. Tiered e-consent for use of de-identified data has traditionally been deemed unnecessary or impractical for implementation in clinical settings. METHODS: We developed a web-based tiered informed consent tool called informed consent for clinical data and bio-sample use for research (iCONCUR) that honors granular patient preferences for use of electronic health record data in research...
September 2, 2016: Journal of the American Medical Informatics Association: JAMIA
Gayle Shier Kricke, Matthew B Carson, Young Ji Lee, Corrine Benacka, R Kannan Mutharasan, Faraz S Ahmad, Preeti Kansal, Clyde W Yancy, Allen S Anderson, Nicholas D Soulakis
OBJECTIVE: Using Failure Mode and Effects Analysis (FMEA) as an example quality improvement approach, our objective was to evaluate whether secondary use of orders, forms, and notes recorded by the electronic health record (EHR) during daily practice can enhance the accuracy of process maps used to guide improvement. We examined discrepancies between expected and observed activities and individuals involved in a high-risk process and devised diagnostic measures for understanding discrepancies that may be used to inform quality improvement planning...
September 1, 2016: Journal of the American Medical Informatics Association: JAMIA
Clare L Brown, Helen L Mulcaster, Katherine L Triffitt, Dean F Sittig, Joan S Ash, Katie Reygate, Andrew K Husband, David W Bates, Sarah P Slight
OBJECTIVE: To understand the different types and causes of prescribing errors associated with computerized provider order entry (CPOE) systems, and recommend improvements in these systems. MATERIALS AND METHODS: We conducted a systematic review of the literature published between January 2004 and June 2015 using three large databases: the Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline. Studies that reported qualitative data about the types and causes of these errors were included...
August 30, 2016: Journal of the American Medical Informatics Association: JAMIA
Jennifer L Hefner, Timothy R Huerta, Ann Scheck McAlearney, Barbara Barash, Tina Latimer, Susan D Moffatt-Bruce
OBJECTIVE: Agency for Healthcare Research and Quality (AHRQ) software applies standardized algorithms to hospital administrative data to identify patient safety indicators (PSIs). The objective of this study was to assess the validity of PSI flags and report reasons for invalid flagging. MATERIAL AND METHODS: At a 6-hospital academic medical center, a retrospective analysis was conducted of all PSIs flagged in fiscal year 2014. A multidisciplinary PSI Quality Team reviewed each flagged PSI based on quarterly reports...
August 30, 2016: Journal of the American Medical Informatics Association: JAMIA
Raj M Ratwani, A Zachary Hettinger, Rollin J Fairbanks
Despite the widespread adoption of electronic health records (EHRs), usability of many EHRs continues to be suboptimal, with some vendors failing to meet usability standards, resulting in clinician frustration and patient safety hazards. In an effort to increase EHR vendor competition on usability, recommendations have been made and legislation drafted to develop comparison tools that would allow purchasers to better understand the usability of EHR products prior to purchase. Usability comparison can be based on EHR vendor design and development processes, vendor usability testing as part of the Office of the National Coordinator for Health Information Technology certification program, and usability of implemented products...
August 29, 2016: Journal of the American Medical Informatics Association: JAMIA
You Chen, Nancy M Lorenzi, Warren S Sandberg, Kelly Wolgast, Bradley A Malin
OBJECTIVE: The goal of this investigation was to determine whether automated approaches can learn patient-oriented care teams via utilization of an electronic medical record (EMR) system. MATERIALS AND METHODS: To perform this investigation, we designed a data-mining framework that relies on a combination of latent topic modeling and network analysis to infer patterns of collaborative teams. We applied the framework to the EMR utilization records of over 10 000 employees and 17 000 inpatients at a large academic medical center during a 4-month window in 2010...
August 28, 2016: Journal of the American Medical Informatics Association: JAMIA
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