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Clinical decision support system

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https://www.readbyqxmd.com/read/29452361/iui-review-and-systematic-assessment-of-the-evidence-that-supports-global-recommendations
#1
Ben Cohlen, Aartjan Bijkerk, Sheryl Van der Poel, Willem Ombelet
BACKGROUND: IUI with or without ovarian stimulation (OS) has become a first-line treatment option for many infertile couples, worldwide. The appropriate treatment modality for couples and their clinical management through IUI or IUI/OS cycles must consider maternal and perinatal outcomes, most notably the clinical complication of higher-order multiple pregnancies associated with IUI-OS. With a current global emphasis to continue to decrease maternal and perinatal mortality and morbidity, the World Health Organization (WHO) had established a multi-year project to review the evidence for the establishment of normative guidance for the implementation of IUI as a treatment to address fertility problems, and to consider its cost-effectiveness for lower resource settings...
February 14, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29449200/mhealth-technology-and-nurse-health-coaching-to-improve-health-in-diabetes-protocol-for-a-randomized-controlled-trial
#2
Sheridan Miyamoto, Madan Dharmar, Sarina Fazio, Yajarayma Tang-Feldman, Heather M Young
BACKGROUND: Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. OBJECTIVE: The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus...
February 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29446193/impact-of-nonintrusive-clinical-decision-support-systems-on-laboratory-test-utilization-in-a-large-academic-centre
#3
Kevin P Eaton, Natasha Chida, Ariella Apfel, Leonard Feldman, Adena Greenbaum, Susan Tuddenham, Emily A Kendall, Amit Pahwa
BACKGROUND: The near-universal prevalence of electronic health records (EHRs) has made the utilization of clinical decision support systems (CDSS) an integral strategy for improving the value of laboratory ordering. Few studies have examined the effectiveness of nonintrusive CDSS on inpatient laboratory utilization in large academic centres. METHODS: Red blood cell folate, hepatitis C virus viral loads and genotypes, and type and screens were selected for study...
February 15, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29444767/patient-reported-measures-for-person-centered-coordinated-care-a-comparative-domain-map-and-web-based-compendium-for-supporting-policy-development-and-implementation
#4
Helen Lloyd, Hannah Wheat, Jane Horrell, Thavapriya Sugavanam, Benjamin Fosh, Jose M Valderas, James Close
BACKGROUND: Patient-reported measure (PRM) questionnaires were originally used in research to measure outcomes of intervention studies. They have now evolved into a diverse family of tools measuring a range of constructs including quality of life and experiences of care. Current health and social care policy increasingly advocates their use for embedding the patient voice into service redesign through new models of care such as person-centered coordinated care (P3C). If chosen carefully and used efficiently, these tools can help improve care delivery through a variety of novel ways, including system-level feedback for health care management and commissioning...
February 14, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29437488/a-stepwise-procedure-to-define-a-data-collection-framework-for-a-clinical-biobank
#5
Peggy Manders, Tessa M A Peters, Ariaan E Siezen, Iris A L M van Rooij, Roger Snijder, Dorine W Swinkels, Gerhard A Zielhuis
INTRODUCTION: Current guidelines for clinical biobanking have a strong focus on obtaining, handling, and storage of biospecimens. However, to allow for research tying biomarker analysis to clinical decision making, there should be more focus on collection of data on donor characteristics. Therefore, our aim was to develop a stepwise procedure to define a framework as a tool to help start the data collection process in clinical biobanking. MATERIALS AND METHODS: The Radboud Biobank (RB) is a central clinical biobanking facility designed in accordance with the standards set by the Parelsnoer Institute, a Dutch national biobank originally initiated with eight different disease cohorts...
February 13, 2018: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/29436470/improving-medication-related-clinical-decision-support
#6
Clare L Tolley, Sarah P Slight, Andrew K Husband, Neil Watson, David W Bates
PURPOSE: Current uses of medication-related clinical decision support (CDS) and recommendations for improving these systems are reviewed. SUMMARY: Using a systematic approach, articles published from 2007 through 2014 were identified in MEDLINE and EMBASE using MeSH terms and keywords relating to the 5 basic medication-related CDS functionalities. A total of 156 full-text articles and 28 conference abstracts were reviewed across each of the 5 areas: drug-drug interaction (DDI) checks ( n = 78), drug allergy checks ( n = 20), drug dose support ( n = 55), drug duplication checks ( n = 11), and drug formulary support ( n = 20)...
February 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29433958/an-ontology-driven-clinical-decision-support-system-iddap-for-infectious-disease-diagnosis-and-antibiotic-prescription
#7
Ying Shen, Kaiqi Yuan, Daoyuan Chen, Joël Colloc, Min Yang, Yaliang Li, Kai Lei
BACKGROUND: The available antibiotic decision-making systems were developed from a physician's perspective. However, because infectious diseases are common, many patients desire access to knowledge via a search engine. Although the use of antibiotics should, in principle, be subject to a doctor's advice, many patients take them without authorization, and some people cannot easily or rapidly consult a doctor. In such cases, a reliable antibiotic prescription support system is needed. METHODS AND RESULTS: This study describes the construction and optimization of the sensitivity and specificity of a decision support system named IDDAP, which is based on ontologies for infectious disease diagnosis and antibiotic therapy...
February 9, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29432220/severity-scoring-systems-for-pneumonia-current-understanding-and-next-steps
#8
Otavio T Ranzani, Leandro Utino Taniguchi, Antoni Torres
PURPOSE OF REVIEW: To describe the current understanding and clinical applicability of severity scoring systems in pneumonia management. RECENT FINDINGS: Severity scores in community-acquired pneumonia are strong markers of mortality, but are not necessarily clinical decision-aid tools. The use of severity scores to support outpatient care in low-risk patients has moderate-to-strong evidence available in the literature, mainly for the pneumonia severity index, and must be applied together with clinical judgment...
February 8, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29431532/a-29-year-analysis-of-acute-peak-salicylate-concentrations-in-fatalities-reported-to-united-states-poison-centers
#9
Brandon J Warrick, Andrew King, Susan Smolinske, Ronald Thomas, Cynthia Aaron
BACKGROUND/OBJECTIVES: The threshold salicylate concentration commonly recommended to initiate extracorporeal elimination, in the absence of significant end-organ toxicity, is 100 mg/dL. Unfortunately, the grade of evidence to support this decision is low. Our primary aim is to describe highest reported salicylate concentrations in patients who died from acute salicylate ingestions. Our secondary aim is to determine if age or coingestants varied with highest reported salicylate concentration...
February 12, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29429920/impact-of-a-clinical-pathway-tool-on-appropriate-palliative-radiation-therapy-for-bone-metastases
#10
Lisa S Rotenstein, Alexander O Kerman, Joseph Killoran, Tracy A Balboni, Monica S Krishnan, Allison Taylor, Neil E Martin
PURPOSE: Clinical pathways increase compliance with treatment guidelines, improve outcomes, and reduce costs. Guidelines recommend single fraction radiation therapy (SFRT) for palliation of uncomplicated bone metastases, but implementation is variable. We examined the effects of a pathway tool on SFRT rates in an academic radiation oncology practice. METHODS AND MATERIALS: Using published literature, clinical guidelines, and expert input, we designed a clinical pathway for bone metastases radiation therapy displayed on a Web-based electronic interface...
December 8, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29428222/cost-utility-analysis-in-orthopaedic-trauma-what-pays-a-systematic-review
#11
S Coyle, S Kinsella, B Lenehan, J M Queally
BACKGROUND: As healthcare systems come under ever-increasing pressure to provide more care with fewer resources, emphasis is being placed on value-based systems that maximise quality and minimize cost. The aim of this study was to determine which interventions in fracture care have been demonstrated to be cost effective. METHODS: A systemic review of cost-utility studies on the management of fractures from 1976 to 2015 was carried out using a search of the Cost-Effectiveness Analysis Registry, National Health Service Economic Evaluation Database (NHS EED) and MEDLINE...
January 31, 2018: Injury
https://www.readbyqxmd.com/read/29428076/an-automated-blastomere-identification-method-for-the-evaluation-of-day-2-embryos-during-ivf-icsi-treatments
#12
Charalambos Strouthopoulos, George Anifandis
PURPOSE: Evaluation of human embryos is one of the most important challenges in vitro fertilization (IVF) programs. The morphology and the morphokinetic parameters of the early cleaving embryo are of critical clinical importance. This stage spans the first 48 h post-fertilization, in which the embryo is dividing in smaller blastomeres at specific time-points. The morphology, in combination with the symmetry of the blastomeres seems to be powerful features with strong prognostic value for embryo evaluation...
March 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29428064/automatic-hemolysis-identification-on-aligned-dual-lighting-images-of-cultured-blood-agar-plates
#13
Mattia Savardi, Alessandro Ferrari, Alberto Signoroni
BACKGROUND AND OBJECTIVE: The recent introduction of Full Laboratory Automation systems in clinical microbiology opens to the availability of streams of high definition images representing bacteria culturing plates. This creates new opportunities to support diagnostic decisions through image analysis and interpretation solutions, with an expected high impact on the efficiency of the laboratory workflow and related quality implications. Starting from images acquired under different illumination settings (top-light and back-light), the objective of this work is to design and evaluate a method for the detection and classification of diagnostically relevant hemolysis effects associated with specific bacteria growing on blood agar plates...
March 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29425639/natural-language-processing-of-clinical-notes-for-identification-of-critical-limb-ischemia
#14
Naveed Afzal, Vishnu Priya Mallipeddi, Sunghwan Sohn, Hongfang Liu, Rajeev Chaudhry, Christopher G Scott, Iftikhar J Kullo, Adelaide M Arruda-Olson
BACKGROUND: Critical limb ischemia (CLI) is a complication of advanced peripheral artery disease (PAD) with diagnosis based on the presence of clinical signs and symptoms. However, automated identification of cases from electronic health records (EHRs) is challenging due to absence of a single definitive International Classification of Diseases (ICD-9 or ICD-10) code for CLI. METHODS AND RESULTS: In this study, we extend a previously validated natural language processing (NLP) algorithm for PAD identification to develop and validate a subphenotyping NLP algorithm (CLI-NLP) for identification of CLI cases from clinical notes...
March 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29425636/computerised-decision-support-in-physical-activity-interventions-a-systematic-literature-review
#15
REVIEW
Andreas Triantafyllidis, Dimitris Filos, Jomme Claes, Roselien Buys, Véronique Cornelissen, Evangelia Kouidi, Ioanna Chouvarda, Nicos Maglaveras
BACKGROUND: The benefits of regular physical activity for health and quality of life are unarguable. New information, sensing and communication technologies have the potential to play a critical role in computerised decision support and coaching for physical activity. OBJECTIVES: We provide a literature review of recent research in the development of physical activity interventions employing computerised decision support, their feasibility and effectiveness in healthy and diseased individuals, and map out challenges and future research directions...
March 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29423559/mind-the-gap-results-of-a-multispecialty-survey-on-coordination-of-care-for-peri-procedural-anticoagulation
#16
Jacob E Kurlander, Geoffrey D Barnes, Michelle A Anderson, Brian Haymart, Eva Kline-Rogers, Scott Kaatz, Sameer D Saini, Sarah L Krein, Caroline R Richardson, James B Froehlich
To understand how physicians from various specialties perceive coordination of care when managing peri-procedural anticoagulation. Cross-sectional survey of cardiologists, gastroenterologists, and primary care physicians (PCPs) in an integrated health system (N = 251). The survey began with a vignette of a patient with atrial fibrillation co-managed by his PCP, cardiologist, and an anticoagulation clinic who must hold warfarin for a colonoscopy. Respondents' experiences and opinions around responsibilities and institutional support for managing peri-procedural anticoagulation were elicited using multiple choice questions...
February 8, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29416860/better-safe-than-sorry-frequent-attendance-in-a-hospital-emergency-department-an-exploratory-study
#17
Jo Daniels, Mike Osborn, Cara Davis
Introduction: Pain accounts for the majority of attendances to the Emergency Department (ED), with insufficient alleviation of symptoms resulting in repeated attendance. People who frequently attend the ED are typically considered to be psychologically and socially vulnerable in addition to experiencing health difficulties. This service development study was commissioned to identify the defining characteristics and unmet needs of frequent attenders (FAs) in a UK acute district general hospital ED, with a view to developing strategies to meet the needs of this group...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29412713/mortality-disparities-in-racial-ethnic-minority-groups-in-the-veterans-health-administration-an-evidence-review-and-map
#18
Kim Peterson, Johanna Anderson, Erin Boundy, Lauren Ferguson, Ellen McCleery, Kallie Waldrip
BACKGROUND: Continued racial/ethnic health disparities were recently described as "the most serious and shameful health care issue of our time." Although the 2014 US Affordable Care Act-mandated national insurance coverage expansion has led to significant improvements in health care coverage and access, its effects on life expectancy are not yet known. The Veterans Health Administration (VHA), the largest US integrated health care system, has a sustained commitment to health equity that addresses all 3 stages of health disparities research: detection, understanding determinants, and reduction or elimination...
March 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29409535/dmto-a-realistic-ontology-for-standard-diabetes-mellitus-treatment
#19
Shaker El-Sappagh, Daehan Kwak, Farman Ali, Kyung-Sup Kwak
BACKGROUND: Treatment of type 2 diabetes mellitus (T2DM) is a complex problem. A clinical decision support system (CDSS) based on massive and distributed electronic health record data can facilitate the automation of this process and enhance its accuracy. The most important component of any CDSS is its knowledge base. This knowledge base can be formulated using ontologies. The formal description logic of ontology supports the inference of hidden knowledge. Building a complete, coherent, consistent, interoperable, and sharable ontology is a challenge...
February 6, 2018: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/29409033/a-dashboard-based-system-for-supporting-diabetes-care
#20
Arianna Dagliati, Lucia Sacchi, Valentina Tibollo, Giulia Cogni, Marsida Teliti, Antonio Martinez-Millana, Vicente Traver, Daniele Segagni, Jorge Posada, Manuel Ottaviano, Giuseppe Fico, Maria Teresa Arredondo, Pasquale De Cata, Luca Chiovato, Riccardo Bellazzi
Objective: To describe the development, as part of the European Union MOSAIC (Models and Simulation Techniques for Discovering Diabetes Influence Factors) project, of a dashboard-based system for the management of type 2 diabetes and assess its impact on clinical practice. Methods: The MOSAIC dashboard system is based on predictive modeling, longitudinal data analytics, and the reuse and integration of data from hospitals and public health repositories. Data are merged into an i2b2 data warehouse, which feeds a set of advanced temporal analytic models, including temporal abstractions, care-flow mining, drug exposure pattern detection, and risk-prediction models for type 2 diabetes complications...
February 2, 2018: Journal of the American Medical Informatics Association: JAMIA
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