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https://www.readbyqxmd.com/read/28645207/development-and-validation-of-an-electronic-medical-record-emr-based-computed-phenotype-of-hiv-1-infection
#1
Devon W Paul, Nigel B Neely, Meredith Clement, Isaretta Riley, Mashael Al-Hegelan, Matthew Phelan, Monica Kraft, David M Murdoch, Joseph Lucas, John Bartlett, Mehri McKellar, Loretta G Que
Background: Electronic medical record (EMR) computed algorithms allow investigators to screen thousands of patient records to identify specific disease cases. No computed algorithms have been developed to detect all cases of human immunodeficiency virus (HIV) infection using administrative, laboratory, and clinical documentation data outside of the Veterans Health Administration. We developed novel EMR-based algorithms for HIV detection and validated them in a cohort of subjects in the Duke University Health System (DUHS)...
June 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28644706/advance-care-planning-and-palliative-care-integration-for-patients-undergoing-hematopoietic-stem-cell-transplantation
#2
Winnie S Wang, Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric J Roeland
PURPOSE: Advance care planning (ACP) in hematopoietic stem-cell transplantation (HSCT) is challenging, given the potential for cure despite increased morbidity and mortality risk.The aim of this study was to evaluate ACP and palliative care (PC) integration for patients who underwent HSCT. METHODS: A retrospective analysis was conducted and data were extracted from electronic medical records of patients who underwent HSCT between January 2011 and December 2015. Patients who received more than one transplant and who were younger than 18 years of age were excluded...
June 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28644586/medical-record-weight-mrw-a-new-reliable-predictor-of-hospital-stay-morbidity-and-mortality-in-the-hip-fracture-population
#3
P Calpin, K Taheny, J F Baker, J Green, J P McCabe
We sought to compare the weight of patient's medical records (MRW) to that of standardised surgical risk scoring systems in predicting postoperative hospital stay, morbidity, and mortality in patients with hip fracture. Patients admitted for surgical treatment of a newly diagnosed hip fracture over a 3-month period were enrolled. Patients with documented morbidity or mortality had significantly heavier medical records. The MRW was equivalent to the age-adjusted Charlson co-morbidity index and better than the American Society of Anaesthesiologists physical status score (ASA), the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM,) and Portsmouth-POSSUM score (P-POSSUM) in correlation with length of hospital admission, p = ...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28644513/benign-vascular-lesions-of-the-breast-diagnosed-by-core-needle-biopsy-do-not-require-excision
#4
Christopher Sebastiano, Lucas Gennaro, Edi Brogi, Elizabeth Morris, Zenica L Bowser, Cristina R Antonescu, Fresia Pareja, Sandra Brennan, Melissa P Murray
AIMS: Surgical excision of all benign vascular lesions of the breast identified by core needle biopsy has been recommended in the past to rule out a more serious lesion. In this study we investigated the clinical, radiologic, and pathologic findings in patients diagnosed with a benign vascular lesion at our institution to assess whether excision may be spared for lesions without atypia. METHODS AND RESULTS: We searched the electronic medical record for patients with a vascular lesion of the breast diagnosed between 2000 and 2015...
June 23, 2017: Histopathology
https://www.readbyqxmd.com/read/28644205/the-unrecognized-epidemic-of-electronic-cigarette-burns
#5
Jesus I Ramirez, Catherine A Ridgway, Jeanne G Lee, Bruce M Potenza, Soman Sen, Tina L Palmieri, David G Greenhalgh, Pirko Maguina
Electronic cigarettes (e-cigarettes) are novel battery-operated devices that deliver nicotine as an inhaled aerosol. They originated from China in 2007 and their use has rapidly increased worldwide in the past decade, yet they remain largely unregulated. Reports of injuries associated with their use have appeared as unusual events in the news media and as case reports in the medical literature. This study was undertaken to explore e-cigarettes as a mechanism of burn injury. Referral records to three burn centers from January 2007 to July 2016 were searched to identify patients with injuries caused by e-cigarettes...
July 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28643799/appropriateness-of-quality-standards-for-meaningful-intercentre-comparisons-of-aflibercept-service-provision-for-neovascular-age-related-macular-degeneration
#6
J S Talks, P James, S Sivaprasad, R L Johnston, M McKibbin
PurposeReal-world data give different information on health-care delivery compared with randomised controlled trials. We aimed to evaluate the appropriateness of possible quality standards for intersite comparisons of outcomes of providing Aflibercept for neovascular age-related macular degeneration (nAMD) in clinical practice.Patients and methodsRetrospective data analysis from an electronic medical record. A consecutive series of treatment-naive patients initiated on aflibercept for nAMD, in the UK from March 2013 to October 2015...
June 23, 2017: Eye
https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#7
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28641996/impact-of-paliperidone-palmitate-versus-oral-atypical-antipsychotics-on-health-care-resource-use-and-costs-in-veterans-with-schizophrenia-and-comorbid-substance-abuse
#8
Patrick Lefebvre, Erik Muser, Kruti Joshi, Maral DerSarkissian, Rachel H Bhak, Mei Sheng Duh, Brian Shiner, Yinong Young-Xu
PURPOSE: Almost half of all patients diagnosed with schizophrenia have a history of substance abuse (SA). However, data on treatment of schizophrenia with paliperidone palmitate (PP) among patients with comorbid SA are limited. The objective of this study was to compare all-cause and SA-related health care resource utilization and costs in veterans with schizophrenia and co-occurring SA who were treated with PP versus oral atypical antipsychotics (OAAs). METHODS: Veterans Health Administration electronic health record data were used to conduct a retrospective longitudinal study in veterans with schizophrenia who initiated PP or OAA between January 1, 2010 and June 30, 2016, had ≥12 months of enrollment before treatment initiation (baseline), were diagnosed with SA, and had ≥1 Global Assessment of Functioning score during baseline...
June 19, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28641497/a-neuropsychiatric-analysis-of-the-cotard-delusion
#9
Aradhana Sahoo, Keith A Josephs
Cotard's syndrome, a condition in which the patient denies his or her own existence or the existence of body parts, is a rare illness that has been reported in association with several neuropsychiatric diagnoses. The majority of published literature on the topic is in the form of case reports, many of which are several years old. The authors evaluated associated diagnoses, neuroimaging, and treatments recorded in patients diagnosed with Cotard's syndrome at their institution. A search of the Mayo Clinic database for patients with mention of signs and symptoms associated with Cotard's in their records between 1996 and 2016 was conducted...
June 23, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28641385/development-of-an-electronic-medical-record-based-child-physical-abuse-alert-system
#10
Rachel P Berger, Richard A Saladino, Janet Fromkin, Emily Heineman, Srinivasan Suresh, Tom McGinn
Objective: Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes. Methods: Triggers to identify children < 2 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center...
June 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28641073/gonorrhoea-testing-and-positivity-in-non-remote-aboriginal-community-controlled-health-services
#11
Mary Ellen Harrod, Sophia Couzos, James Ward, Mark Saunders, Basil Donovan, Belinda Hammond, Dea Delaney-Thiele, Mary Belfrage, Sid Williams, Lucy Watchirs Smith, John M Kaldor
Background: Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15-54 years from 2009 to 2013...
June 22, 2017: Sexual Health
https://www.readbyqxmd.com/read/28639832/comparing-diagnostic-performance-of-digital-breast-tomosynthesis-and-full-field-digital-mammography-in-a-hybrid-screening-environment
#12
Catherine S Giess, Sarvenaz Pourjabbar, Ivan K Ip, Ronilda Lacson, Emily Alper, Ramin Khorasani
OBJECTIVE: The purpose of this study is to compare the diagnostic performance of screening digital breast tomosynthesis (DBT) to that of full-field digital mammography (FFDM) in a mixed DBT and FFDM imaging environment. MATERIALS AND METHODS: This retrospective observational study consisted of all female patients undergoing screening DBT or FFDM at an academic medical center and outpatient imaging facility between October 2012 and May 2015. Patient demographics and personal history of breast cancer were collected from the electronic medical record...
June 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28639489/healthcare-provider-education-to-support-integration-of-pharmacogenomics-in-practice-the-emerge-network-experience
#13
Carolyn R Rohrer Vitek, Noura S Abul-Husn, John J Connolly, Andrea L Hartzler, Terrie Kitchner, Josh F Peterson, Luke V Rasmussen, Maureen E Smith, Sarah Stallings, Marc S Williams, Wendy A Wolf, Cynthia A Prows
Ten organizations within the Electronic Medical Records and Genomics Network developed programs to implement pharmacogenomic sequencing and clinical decision support into clinical settings. Recognizing the importance of informed prescribers, a variety of strategies were used to incorporate provider education to support implementation. Education experiences with pharmacogenomics are described within the context of each organization's prior involvement, including the scope and scale of implementation specific to their Electronic Medical Records and Genomics projects...
June 22, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28638539/the-electronic-health-record-a-blessing-for-patient-safety-but-a-curse-for-medical-education
#14
EDITORIAL
Ali Naderi Mahabadi
No abstract text is available yet for this article.
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28638518/automated-reporting-of-trainee-metrics-using-electronic-clinical-systems
#15
Jonathan C Levin, Jonathan Hron
BACKGROUND: The Accreditation Council for Graduate Medical Education has called for increased emphasis on reporting objective performance measures to trainees and programs. However, reporting of objective measures, including clinical volume, is largely omitted from training programs. OBJECTIVE: To use automated electronic medical systems at a tertiary pediatric care hospital to create a dashboard that reports objective trainee and program metrics, including clinical volume and diagnoses in a pediatrics residency...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28638451/antiemetic-effectiveness-and-cost-saving-of-aprepitant-plus-granisetron-is-superior-to-palonosetron-in-gastrointestinal-cancer-patients-who-received-moderately-emetogenic-chemotherapy
#16
Haruka Toda, Hitoshi Kawazoe, Akiko Yano, Yuji Yamamoto, Yuji Watanabe, Yasunori Yamamoto, Yoichi Hiasa, Yoshihiro Yakushijin, Akihiro Tanaka, Hiroaki Araki
Purpose The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC. Methods We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28637570/risk-factors-that-predict-recurrent-clostridium-difficile-infections-in-surgical-patients
#17
Craig A Messick, Jeff P Hammel, Tracy Hull
Clostridium difficile (C. difficile) infection (CDI) is a serious problem mostly studied during patients' index infections. The aim of this study is to define the incidence of primary and recurrent postoperative (postop) CDI in a single institution's entire surgical population and to identify risk factors that influence disease recurrence. Using electronic medical records from 2002 to 2012, charts were reviewed from all patients with laboratory-proven (enzyme-linked immunosorbent assay or polymerase chain reaction methods) C...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636784/audio-computer-assisted-survey-interview-and-patient-navigation-to-increase-chronic-viral-hepatitis-diagnosis-and-linkage-to-care-in-urban-health-clinics
#18
A N de la Torre, I Castaneda, M Ahmad, N Ekholy, N Tham, I B Herrera, P Beaty, R J Malapero, Farhan Ayoub, J Slim, M B Johnson
Intravenous drug use and sexual practices account for 60% of hepatitis C (HCV) and B (HBV) infection. Disclosing these activities can be embarrassing, reduce risk reporting, blood testing and diagnosis. In diagnosed patients, linkage to care remains a challenge. Audio-computer assisted survey interview (Audio-CASI) was used to guide HCV and HBV infection testing in urban clinics. Risk reporting, blood-testing, and serology results were compared to historical controls. A Patient Navigator (PN) followed up blood test results and provided patients with positive serology linkage to care...
June 21, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28636072/using-chief-complaint-in-addition-to-diagnosis-codes-to-identify-falls-in-the-emergency-department
#19
Brian W Patterson, Maureen A Smith, Michael D Repplinger, Michael S Pulia, James E Svenson, Michael K Kim, Manish N Shah
OBJECTIVES: To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. DESIGN: Retrospective electronic record review. SETTING: Academic medical center ED. PARTICIPANTS: Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28634873/evaluating-two-evidence-based-intervention-strategies-to-promote-crc-screening-among-latino-adults-in-a-primary-care-setting
#20
Sheila F Castañeda, Balambal Bharti, Rebeca Aurora Espinoza-Giacinto, Valerie Sanchez, Shawne O'Connell, Fatima Muñoz, Sylvia Mercado, Marie Elena Meza, Wendy Rojas, Gregory A Talavera, Samir Gupta
Regular use of colorectal cancer screening can reduce incidence and mortality, but participation rates remain low among low-income, Spanish-speaking Latino adults. We conducted two distinct pilot studies testing the implementation of evidence-based interventions to promote fecal immunochemical test (FIT) screening among Latinos aged 50-75 years who were not up-to-date with CRC screening (n = 200) at a large Federally Qualified Health Center (FQHC) in San Diego, CA. One pilot focused on an opportunistic clinic visit "in-reach" intervention including a 30-min session with a patient navigator, review of an educational "flip-chart," and a take-home FIT kit with instructions...
June 20, 2017: Journal of Racial and Ethnic Health Disparities
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