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Clinical decision support system

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https://www.readbyqxmd.com/read/29679019/clinical-assistant-diagnosis-for-electronic-medical-record-based-on-convolutional-neural-network
#1
Zhongliang Yang, Yongfeng Huang, Yiran Jiang, Yuxi Sun, Yu-Jin Zhang, Pengcheng Luo
Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases...
April 20, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29678088/translating-ehealth-visions-from-strategy-to-practice-a-benefit-management-approach
#2
Sidsel Villumsen, Christian Nøhr, Arild Faxvaag
The municipalities and the Regional Health Authorities in Central Norway have been assigned a mandate to implement a shared electronic health record, Helseplattformen, reflecting the visions set out in the national eHealth white paper 'One Citizen - One Record'. This study identifies and describe anticipated benefit streams of clinical decision support in 'One Citizen - One Record' and the user requirement specification documents of Helseplattformen. This study found that the benefit stream of clinical decision support translates from the health policy visions stated in 'One Citizen - One Record' into Helseplattformen...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29678086/implementing-systems-medicine-a-medical-informatics-perspective
#3
Matthias Ganzinger, Matthias Gietzelt, Christian Karmen, Blanca Flores, Petra Knaup
Systems medicine is a paradigm for translating in silico methods developed for modelling biological systems into the field of medicine. Such approaches rely on the integration of as many data sources as possible, both in the dimension of disease knowledge and patient data. This is a challenging task that can only be implemented in clinical routine with the help of suitable information technology from the field of Medical Informatics. For the research project "Clinically-applicable, omics-based assessment of survival, side effects, and targets in multiple myeloma" (CLIOMMICS) we developed a prototypical systems medicine application system...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29678085/implementing-pharmacogenomic-clinical-decision-support-into-german-hospitals
#4
Marc Hinderer, Melanie Boerries, Martin Boeker, Michael Neumaier, Frank-Peter Loubal, Till Acker, Manfred Brunner, Hans-Ulrich Prokosch, Jan Christoph
BACKGROUND: Pharmacogenomic Clinical Decision Support Systems (CDSS) are considered to be the most feasible tool for adopting pharmacogenomic testing into clinical routine. OBJECTIVE: To discuss important factors for implementing pharmacogenomic CDSS into German hospitals. METHODS: We analyzed two relevant studies. Furthermore, we interviewed data privacy officers of three German university hospitals and examined relevant legal regulations in literature...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29678061/personalised-care-plan-management-utilizing-guideline-driven-clinical-decision-support-systems
#5
Gokce Banu Laleci Erturkmen, Mustafa Yuksel, Bunyamin Sarigul, Mikael Lilja, Rong Chen, Theodoros N Arvanitis
Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29678045/approach-towards-an-evidence-oriented-knowledge-and-data-acquisition-for-the-optimization-of-interdisciplinary-care-in-dentistry-and-general-medicine
#6
Max W Seitz, Christian Haux, Petra Knaup, Ingrid Schubert, Stefan Listl
Associations between dental and chronic-systemic diseases were observed frequently in medical research, however the findings of this research have so far found little relevance in everyday clinical treatment. Major problems are the assessment of evidence for correlations between such diseases and how to integrate current medical knowledge into the intersectoral care of dentists and general practitioners. On the example of dental and chronic-systemic diseases, the Dent@Prevent project develops an interdisciplinary decision support system (DSS), which provides the specialists with information relevant for the treatment of such cases...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677937/applying-the-zone-of-proximal-development-when-evaluating-clinical-decision-support-systems-a-case-study
#7
Helena Lindgren, Ming-Hsin Lu, Yeji Hong, Chunli Yan
The goal to facilitate a continuing medical education can be incorporated in the design of a clinical decision-support system. Developing a method for evaluating knowledge and skill development as part of evaluating the system is the aim for the research presented in this paper. The activity supported by the system was analyzed using Activity theory and structured into a protocol. Four clinicians were studied using the system for the first time, and their activity were assessed using the concept of Zone of Proximal Development...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29674373/study-protocol-quantitative-fibronectin-to-help-decision-making-in-women-with-symptoms-of-preterm-labour-quids-part-2-uk-prospective-cohort-study
#8
Sarah Jane Stock, Lisa M Wotherspoon, Kathleen Anne Boyd, Rachel K Morris, Jon Dorling, Lesley Jackson, Manju Chandiramani, Anna L David, Asma Khalil, Andrew Shennan, Victoria Hodgetts Morton, Tina Lavender, Khalid Khan, Susan Harper-Clarke, Ben Mol, Richard D Riley, John Norrie, Jane Norman
INTRODUCTION: The aim of the QUIDS study is to develop a decision support tool for the management of women with symptoms and signs of preterm labour, based on a validated prognostic model using quantitative fetal fibronectin (fFN) concentration, in combination with clinical risk factors. METHODS AND ANALYSIS: The study will evaluate the Rapid fFN 10Q System (Hologic, Marlborough, Massachusetts, USA) which quantifies fFN in a vaginal swab. In QUIDS part 2, we will perform a prospective cohort study in at least eight UK consultant-led maternity units, in women with symptoms of preterm labour at 22+0  to 34+6 weeks gestation to externally validate a prognostic model developed in QUIDS part 1...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673607/impact-of-a-hybrid-decision-support-system-to-improve-the-adherence-to-implantable-cardioverter-defibrillator-therapy-guidelines-for-primary-prevention-of-sudden-cardiac-death
#9
Nicolás Vecchio, Diego Belardi, Mariano Benzadón, Leonardo Seoane, Gustavo Daquarti, Fernando Scazzuso
OBJECTIVES: Despite the well-documented benefit of implantable cardioverter defibrillator (ICD) in patients with severe left ventricular dysfunction, there is a large number of patients who had not been offered this therapy. The aim of this study is to evaluate the utility of a hybrid decision support system (hCDSS) to improve the adherence to indicate ICD therapy in our institution. METHODS: We conducted a retrospective, observational and single-center study. An hCDSS focused on patients with severe deterioration of the left ventricular function was implemented, creating a mandatory field containing the value of left ejection fraction and three options to choose: >35%, ≤ 35% or unknown...
June 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29673601/decision-support-system-for-triage-management-a-hybrid-approach-using-rule-based-reasoning-and-fuzzy-logic
#10
Mahsa Dehghani Soufi, Taha Samad-Soltani, Samad Shams Vahdati, Peyman Rezaei-Hachesu
OBJECTIVES: Fast and accurate patient triage for the response process is a critical first step in emergency situations. This process is often performed using a paper-based mode, which intensifies workload and difficulty, wastes time, and is at risk of human errors. This study aims to design and evaluate a decision support system (DSS) to determine the triage level. METHODS: A combination of the Rule-Based Reasoning (RBR) and Fuzzy Logic Classifier (FLC) approaches were used to predict the triage level of patients according to the triage specialist's opinions and Emergency Severity Index (ESI) guidelines...
June 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29672521/acceptance-and-barriers-pertaining-to-a-general-practice-decision-support-system-for-multiple-clinical-conditions-a-mixed-methods-evaluation
#11
Derk L Arts, Stephanie K Medlock, Henk C P M van Weert, Jeremy C Wyatt, Ameen Abu-Hanna
BACKGROUND: Many studies have investigated the use of clinical decision support systems as a means to improve care, but have thus far failed to show significant effects on patient-related outcomes. We developed a clinical decision support system that attempted to address issues that were identified in these studies. The system was implemented in Dutch general practice and was designed to be both unobtrusive and to respond in real time. Despite our efforts, usage of the system was low...
2018: PloS One
https://www.readbyqxmd.com/read/29672424/the-struggle-is-real-investigating-the-challenge-of-assigning-a-failing-clinical-grade
#12
Jeannie Couper
AIM: The aim of the study was to explore the relationships between role strain, faculty stress, and perceived organizational support for nurse faculty who faced the decision to assign a failing clinical grade. BACKGROUND: Although faculty are responsible for assigning a grade reflecting students' competence and ability to practice safely, faculty find it troublesome and stressful to assign a failing clinical grade. METHOD: A national sample consisting of 390 nursing faculty completed an online four-part questionnaire with an open-ended question...
May 2018: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29672242/developing-and-implementing-a-heart-failure-data-mart-for-research-and-quality-improvement
#13
Erin Abu-Rish Blakeney, Seth Wolpin, Danielle C Lavallee, Todd Dardas, Richard Cheng, Brenda Zierler
OBJECTIVE: The purpose of this project was to build and formatively evaluate a near-real time heart failure (HF) data mart. Heart Failure (HF) is a leading cause of hospital readmissions. Increased efforts to use data meaningfully may enable healthcare organizations to better evaluate effectiveness of care pathways and quality improvements, and to prospectively identify risk among HF patients. METHODS AND PROCEDURES: We followed a modified version of the Systems Development Life Cycle: 1) Conceptualization, 2) Requirements Analysis, 3) Iterative Development, and 4) Application Release...
April 19, 2018: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/29669706/reasons-for-physicians-not-adopting-clinical-decision-support-systems-critical-analysis
#14
REVIEW
Saif Khairat, David Marc, William Crosby, Ali Al Sanousi
BACKGROUND: Clinical decision support systems (CDSSs) are an integral component of today's health information technologies. They assist with interpretation, diagnosis, and treatment. A CDSS can be embedded throughout the patient safety continuum providing reminders, recommendations, and alerts to health care providers. Although CDSSs have been shown to reduce medical errors and improve patient outcomes, they have fallen short of their full potential. User acceptance has been identified as one of the potential reasons for this shortfall...
April 18, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29665763/neuroimaging-radiological-interpretation-system-niris-for-acute-traumatic-brain-injury-tbi
#15
Max Wintermark, Ying Li, Victoria Y Ding, Yingding Xu, Bin Jiang, Robyn L Ball, Michael Zeineh, Alisa Gean, Pina Sanelli
To develop an outcome-based NeuroImaging Radiological Interpretation System (NIRIS) for acute traumatic brain injury (TBI) patients that would standardize the interpretation of non-contrast head CTs and consolidate imaging findings into ordinal severity categories that would inform specific patient management actions and that could be used as a clinical decision support tool. We retrospectively identified all patients transported to our emergency department by ambulance or helicopter, for whom a trauma alert was triggered per established criteria and who underwent a non-contrast head CT due to suspicion of TBI, between November 2015 and April 2016...
April 18, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29659856/integration-of-physical-abuse-clinical-decision-support-into-the-electronic-health-record-at-a-tertiary-care-children-s-hospital
#16
Srinivasan Suresh, Richard A Saladino, Janet Fromkin, Emily Heineman, Tom McGinn, Rudolph Richichi, Rachel P Berger
Objective: To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. Methods: A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set...
April 12, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29655933/-document-management-systems-to-support-quality-management-systems-at-university-hospitals-an-interview-based-study
#17
Martin Holderried, Ann-Catrin Bökel, Elke Ochsmann
In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring...
April 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29650310/electronic-health-record-with-computerized-decision-support-tools-for-the-purposes-of-a-pediatric-cardiovascular-heart-disease-screening-program-in-crete
#18
Ilias Chatzakis, Kostas Vassilakis, Christos Lionis, Ioannis Germanakis
BACKGROUND AND OBJECTIVE: Early detection of cardiovascular (CV) disease or associated risk factors during childhood is of paramount importance, allowing for early treatment or lifestyle modifications, respectively. The objective of this study was to describe the development of an electronic health record (EHR), with integrated computerized decision support system (CDSS), specifically designed for supporting the needs of a pilot pediatric CV disease screening program applied on primary school students of a Mediterranean island...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29649602/point-of-care-and-point-of-can-leveraging-reference-laboratory-capacity-for-integrated-diagnosis-of-fever-syndromes-in-the-tropics
#19
REVIEW
Makeda Semret, Momar Ndao, Jan Jacobs, Cedric P Yansouni
BACKGROUND: There is an urgent need for integrated diagnosis of febrile syndromes, able to account for multiple pathogens and inform decisions for clinical care and public health. AIMS: To reflect on the evolving roles of laboratory-based testing for non-malarial febrile illnesses (NMFI) in low-resource settings (LRS), and to consider how advances in diagnostics, in connectivity and transport, and in quality-systems implementation may substantially enhance the capacity of reference laboratories to bridge the current gap between remote passive surveillance and clinically meaningful integrated fever diagnosis...
April 9, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29644533/systematic-review-of-clinical-outcomes-following-various-treatment-options-for-patients-with-extraabdominal-desmoid-tumors
#20
Kortnye Smith, Jayesh Desai, Smaro Lazarakis, David Gyorki
BACKGROUND: Desmoid tumors (DT) are rare clonal proliferations that arise from mesenchymal cells. These tumors do not metastasize but are locally aggressive, and their growth may lead to significant morbidity. Their clinical course is both variable and unpredictable; tumors may rapidly progress but in other instances remain stable or regress without intervention. AIMS: To examine current treatment of DT and assist with decision-making at time of presentation. METHODS: A literature search was conducted of MEDLINE and Cochrane databases for published studies (1995-July 2015) using the search terms fibromatosis aggressive, desmoid with drug therapy, radiation therapy, prevention and control, radiotherapy, surgery, and therapy...
April 11, 2018: Annals of Surgical Oncology
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