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https://www.readbyqxmd.com/read/27905352/-future-perspective-of-pharmacoepidemiology-in-the-big-data-era-and-the-growth-of-information-sources
#1
Diego Macías Saint-Gerons, César de la Fuente Honrubia, Fernando de Andrés Trelles, Ferrán Catalá-López Catalá-López
The arrival of new drug into the market requires many years of previous research along with the need of continuous evaluation throughout the lifetime of the drug. This warrants pharmacoepidemiological research which may be defined as the study of the use and the effects of drugs in large populations. Nowadays this type of research seems more feasible thanks to the massive expansion of the information sources and data (e.g: clinical patient registries, electronic medical records). However there is a risk of information overload, fragmented evidence and given the enthusiasm aroused by the "Big Data", it must be emphasized that its nature is mainly observational, and therefore subject to bias and confusion...
December 1, 2016: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/27904042/risk-factors-associated-with-cisplatin-induced-nephrotoxicity-in-patients-with-advanced-lung-cancer
#2
Takanori Miyoshi, Nobuhiro Misumi, Mikako Hiraike, Yuki Mihara, Takashi Nishino, Minako Tsuruta, Yosei Kawamata, Yoichi Hiraki, Aki Kozono, Masao Ichiki
Cisplatin (CDDP) combination chemotherapy is widely administered to patients with advanced lung cancer. The dose depends on multiple factors, including whether the tumor is non-small-cell lung cancer (NSCLC) or small-cell lung cancer (SCLC). Although efficacy is limited by cisplatin-induced nephrotoxicity (CIN), little is known about the risk factors for this complication. The aim of this study was to identify the risk factors for CIN in patients with advanced lung cancer, both NSCLC and SCLC. We retrospectively reviewed clinical data for 148 patients who underwent initial chemotherapy including CDDP ≥50 mg/m(2) per patient per day for the first course at Kyushu Medical Center between October 2010 and September 2013...
2016: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/27903614/association-between-inpatient-sleep-loss-and-hyperglycemia-of-hospitalization
#3
Regina H DePietro, Kristen L Knutson, Lisa Spampinato, Samantha L Anderson, David O Meltzer, Eve Van Cauter, Vineet M Arora
OBJECTIVE: To determine whether inpatient sleep duration and efficiency are associated with a greater risk of hyperglycemia in hospitalized patients with and without diabetes. RESEARCH DESIGN AND METHODS: In this retrospective analysis of a prospective cohort study, medical inpatients ≥50 years of age were interviewed, and their charts were reviewed to obtain demographic data and diagnosis. Using World Health Organization criteria, patients were categorized as having normal blood glucose, impaired fasting blood glucose, or hyperglycemia based on morning glucose from the electronic health record...
November 30, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27903489/finding-important-terms-for-patients-in-their-electronic-health-records-a-learning-to-rank-approach-using-expert-annotations
#4
Jinying Chen, Jiaping Zheng, Hong Yu
BACKGROUND: Many health organizations allow patients to access their own electronic health record (EHR) notes through online patient portals as a way to enhance patient-centered care. However, EHR notes are typically long and contain abundant medical jargon that can be difficult for patients to understand. In addition, many medical terms in patients' notes are not directly related to their health care needs. One way to help patients better comprehend their own notes is to reduce information overload and help them focus on medical terms that matter most to them...
November 30, 2016: JMIR Medical Informatics
https://www.readbyqxmd.com/read/27902551/do-years-of-experience-with-electronic-health-records-matter-for-productivity-in-community-health-centers
#5
Bianca K Frogner, Xiaoli Wu, Leighton Ku, Patricia Pittman, Leah E Masselink
This study investigated how years of experience with an electronic health record (EHR) related to productivity in community health centers (CHCs). Using data from the 2012 Uniform Data System, we regressed average annual medical visits, weighted for service intensity, as a function of full-time equivalent medical staff controlling for CHC size and location. Physician productivity significantly improved. Although the productivity of all other staff types was not significantly different by years of EHR experience, the trends showed lower productivity among nurses and other medical staff in CHCs with fewer years of EHR experience versus more years of experience...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27902549/integration-of-medical-scribes-in-the-primary-care-setting-improving-satisfaction
#6
Brian H Imdieke, Marc L Martel
There are little published data on the use of medical scribes in the primary care setting. We assessed the feasibility of incorporating medical scribes in our ambulatory clinic to support provider documentation in the electronic medical record. In our convenience sampling of patient, provider, and staff perceptions of scribes, we found that patients were comfortable having scribes in the clinic. Overall indicators of patient satisfaction were slightly decreased. Providers found scribe support to be valuable and overall clinician documentation time was reduced by more than 50% using scribes...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27900657/the-sawtooth-sign-is-predictive-of-obstructive-sleep-apnea
#7
Michael H Bourne, Paul D Scanlon, Darrell R Schroeder, Eric J Olson
BACKGROUND: The sawtooth sign in spirometry is associated with redundant upper airway tissue and snoring, but its predictive value for identifying obstructive sleep apnea (OSA) is disputed. We retrospectively assessed the predictive value of the spirometric sawtooth sign in terms of the odds ratio (OR) of association with a diagnosis of OSA compared to those without the sign. METHODS: Consecutive spirometry reports showing a sawtooth sign were identified from our laboratory...
November 29, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27900546/validation-of-the-chinese-version-of-functional-assessment-of-anorexia-cachexia-therapy-faact-scale-for-measuring-quality-of-life-in-cancer-patients-with-cachexia
#8
Ting Zhou, Kaixiang Yang, Sudip Thapa, Qiang Fu, Yongsheng Jiang, Shiying Yu
PURPOSE: The assessment of quality of life (QOL) is an important part of cachexia management for cancer patients. Functional assessment of anorexia-cachexia therapy (FAACT), a specific QOL instrument for cachexia patients, has not been validated in Chinese population. The aim of this study was to validate the FAACT scale in Chinese cancer patients for its future use. METHODS: Eligible cancer patients were included in our study. Patients' demographic and clinical characteristics were collected from the electronic medical records...
November 29, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27899338/high-touch-and-high-tech-ht2-proposal-transforming-patient-engagement-throughout-the-continuum-of-care-by-engaging-patients-with-portal-technology-at-the-bedside
#9
Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Alison M Aldrich, Daniel M Walker, Milisa K Rizer, Susan D Moffatt-Bruce, Timothy R Huerta
BACKGROUND: For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge...
November 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#10
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27899049/underreporting-of-complete-uterine-rupture-and-uterine-dehiscence-in-women-with-previous-cesarean-section
#11
Maria Fogelberg, Anton Baranov, Andreas Herbst, Olga Vikhareva
OBJECTIVE: To determine the true incidence of complete uterine rupture and uterine dehiscence among women delivered by cesarean section after a previous cesarean section. METHODS: Medical records of all women who delivered at University Hospital in Malmö, Sweden, during 2005-2009 (n = 21420) were retrieved from the electronic patient record system (EPRS). After adjustment for inaccuracies, 716 women who had undergone repeat cesarean section were identified and their operation reports were reviewed...
November 29, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27898580/resident-compliance-with-the-american-academy-of-ophthalmology-preferred-practice-patterns-for-primary-open-angle-glaucoma-suspect
#12
Melanie Mihlstin, Mark S Juzych, Heidi T Kromrei, Frank S Hwang, Jia Yin
PURPOSE: To study resident compliance with the American Academy of Ophthalmology (AAO) Preferred Practice Patterns (PPPs) for primary open-angle glaucoma suspect (POAGS) in a resident ophthalmology clinic. PATIENTS AND METHODS: Two hundred charts were selected for analysis of adult patients with the International Classification of Diseases diagnosis code for POAGS during their initial visit between November 2, 2010 and May 6, 2014 at the Kresge Eye Institute resident clinic...
December 2016: Journal of Glaucoma
https://www.readbyqxmd.com/read/27898460/a-pilot-comparison-of-a-smartphone-app-with-or-without-2-way-messaging-among-chronic-pain-patients-who-benefits-from-a-pain-app
#13
Robert N Jamison, Dylan C Jurcik, Robert R Edwards, Chuan-Chin Huang, Edgar L Ross
OBJECTIVES: The overall aim of this study was to determine the effect of introducing a smartphone pain app, for both Android and iPhone devices that enables chronic pain patients to assess, monitor, and communicate their status to their providers. METHODS: This study recruited 105 chronic pain patients to use a smartphone pain app and half of the subjects (N=52) had 2-way messaging available through the app. All subjects completed baseline measures and were asked to record their progress every day for 3 months, with the opportunity to continue for 6 months...
November 24, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27897005/strategies-for-equitable-pharmacogenomic-guided-warfarin-dosing-among-european-and-african-american-individuals-in-a-clinical-population
#14
Laura K Wiley, Jacob P Vanhouten, David C Samuels, Melinda C Aldrich, Dan M Roden, Josh F Peterson, Joshua C Denny
The blood thinner warfarin has a narrow therapeutic range and high inter- and intra-patient variability in therapeutic doses. Several studies have shown that pharmacogenomic variants help predict stable warfarin dosing. However, retrospective and randomized controlled trials that employ dosing algorithms incorporating pharmacogenomic variants under perform in African Americans. This study sought to determine if: 1) including additional variants associated with warfarin dose in African Americans, 2) predicting within single ancestry groups rather than a combined population, or 3) using percentage African ancestry rather than observed race, would improve warfarin dosing algorithms in African Americans...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27897004/identifying-genetic-associations-with-variability-in-metabolic-health-and-blood-count-laboratory-values-diving-into-the-quantitative-traits-by-leveraging-longitudinal-data-from-an-ehr
#15
Shefali S Verma, Anastasia M Lucas, Daniel R Lavage, Joseph B Leader, Raghu Metpally, Sarathbabu Krishnamurthy, Frederick Dewey, Ingrid Borecki, Alexander Lopez, John Overton, John Penn, Jeffrey Reid, Sarah A Pendergrass, Gerda Breitwieser, Marylyn D Ritchie
A wide range of patient health data is recorded in Electronic Health Records (EHR). This data includes diagnosis, surgical procedures, clinical laboratory measurements, and medication information. Together this information reflects the patient's medical history. Many studies have efficiently used this data from the EHR to find associations that are clinically relevant, either by utilizing International Classification of Diseases, version 9 (ICD-9) codes or laboratory measurements, or by designing phenotype algorithms to extract case and control status with accuracy from the EHR...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896991/temporal-order-of-disease-pairs-affects-subsequent-disease-trajectories-the-case-of-diabetes-and-sleep-apnea
#16
Mette K Beck, David Westergaard, Anders Boeck Jensen, Leif Groop, Søren Brunak
Most studies of disease etiologies focus on one disease only and not the full spectrum of multimorbidities that many patients have. Some disease pairs have shared causal origins, others represent common follow-on diseases, while yet other co-occurring diseases may manifest themselves in random order of appearance. We discuss these different types of disease co-occurrences, and use the two diseases "sleep apnea" and "diabetes" to showcase the approach which otherwise can be applied to any disease pair. We benefit from seven million electronic medical records covering the entire population of Denmark for more than 20 years...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896989/opening-the-door-to-the-large-scale-use-of-clinical-lab-measures-for-association-testing-exploring-different-methods-for-defining-phenotypes
#17
Christopher R Bauer, Daniel Lavage, John Snyder, Joseph Leader, J Matthew Mahoney, Sarah A Pendergrass
The past decade has seen exponential growth in the numbers of sequenced and genotyped individuals and a corresponding increase in our ability of collect and catalogue phenotypic data for use in the clinic. We now face the challenge of integrating these diverse data in new ways new that can provide useful diagnostics and precise medical interventions for individual patients. One of the first steps in this process is to accurately map the phenotypic consequences of the genetic variation in human populations. The most common approach for this is the genome wide association study (GWAS)...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#18
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896978/development-and-performance-of-text-mining-algorithms-to-extract-socioeconomic-status-from-de-identified-electronic-health-records
#19
Brittany M Hollister, Nicole A Restrepo, Eric Farber-Eger, Dana C Crawford, Melinda C Aldrich, Amy Non
Socioeconomic status (SES) is a fundamental contributor to health, and a key factor underlying racial disparities in disease. However, SES data are rarely included in genetic studies due in part to the difficultly of collecting these data when studies were not originally designed for that purpose. The emergence of large clinic-based biobanks linked to electronic health records (EHRs) provides research access to large patient populations with longitudinal phenotype data captured in structured fields as billing codes, procedure codes, and prescriptions...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896144/clinical-decision-support-for-drug-related-events-moving-towards-better-prevention
#20
REVIEW
Sandra L Kane-Gill, Archita Achanta, John A Kellum, Steven M Handler
Clinical decision support (CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors (ME) and adverse drug events (ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur...
November 4, 2016: World Journal of Critical Care Medicine
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