Read by QxMD icon Read

Decision support tools

Stephanie E Lessing, Laura L Hayman
BACKGROUND: Diabetes treatment and management provide a unique opportunity for examination of the effectiveness of electronic health records (EHRs) on patient health outcomes, continuity of care, and areas for further development. This systematic literature review was designed to identify the strengths and limitations of EHR and opportunities for improvement proposed in original research and recent rigorous systematic reviews. METHODS: This review utilized methodology adapted from PRISMA...
December 17, 2018: Journal of Diabetes Science and Technology
A Cado, J Nicli, B Bourgois, L Vallée, M-P Lemaitre
Children with a written language disorder are sometimes dependent upon help from others for their schoolwork. A computer can be a way to circumvent this difficulty. Various software programs and plug-in peripheral devices are available, some of which specifically target the needs of these young people. There is no consensus, however, with regard to how best to counsel parents and children with regard to these tools. Furthermore, written language disorders and existing technical supports are not always clearly understood...
December 13, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Varun Arvind, Jun S Kim, Eric K Oermann, Deepak Kaji, Samuel K Cho
Objective: : Machine learning algorithms excel at leveraging big data to identify complex patterns that can be used to aid in clinical decision-making. The objective of this study is to demonstrate the performance of machine learning models in predicting postoperative complications following anterior cervical discectomy and fusion (ACDF). Methods: : Artificial neural network (ANN), logistic regression (LR), support vector machine (SVM), and random forest decision tree (RF) models were trained on a multicenter data set of patients undergoing ACDF to predict surgical complications based on readily available patient data...
December 17, 2018: Neurospine
Tien Tuan Dao
Skeletal muscle forces may be estimated using rigid musculoskeletal models and neural networks. Neural network (NN) approach has the advantages of real-time estimation ability and promising prediction accuracy. However, most of the developed NN models are based on conventional feedforward NNs, which do not take dynamic temporal relationships of the muscle force profiles into consideration. The objectives of this present paper are twofold: (1) to develop a recurrent deep neural network (RDNN) incorporating dynamic temporal relationships to estimate skeletal muscle forces from kinematics data during a gait cycle; (2) then to establish a transfer learning strategy to improve the accuracy of muscle force estimation...
December 14, 2018: Medical & Biological Engineering & Computing
Ellen G Engelhardt, Dóra Révész, Hans J Tamminga, Cornelis J A Punt, Miriam Koopman, Bregje D Onwuteaka-Philipsen, Ewout W Steyerberg, Henrica C W de Vet, Veerle M H Coupé
BACKGROUND: Decision-making about palliative care for metastatic colorectal cancer (mCRC) consists of many different treatment-related decisions, and there generally is no best treatment option. Decision support systems (DSS), e.g., prognostic calculators, can aid oncologists' decision-making. DSS that contain features tailored to the needs of oncologists are more likely to be implemented in clinical practice. Therefore, our aim is to inventory colorectal cancer specialists' unmet decision support needs...
December 14, 2018: BMC Medical Informatics and Decision Making
Gaelle Saint-Hilary, Valentine Barboux, Matthieu Pannaux, Mauro Gasparini, Veronique Robert, Gianluca Mastrantonio
The predictive probability of success of a future clinical trial is a key quantitative tool for decision-making in drug development. It is derived from prior knowledge and available evidence, and the latter typically comes from the accumulated data on the clinical endpoint of interest in previous clinical trials. However, a surrogate endpoint could be used as primary endpoint in early development and, usually, no or limited data are collected on the clinical endpoint of interest. We propose a general, reliable, and broadly applicable methodology to predict the success of a future trial from surrogate endpoints, in a way that makes the best use of all the available evidence...
December 12, 2018: Statistics in Medicine
Maria Noonan, Owen Doody, Andrew O'Regan, Julie Jomeen, Rose Galvin
BACKGROUND: Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and supporting women and this study aimed to explore GPs' experiences of caring for women with perinatal mental health problems in primary care. The results of this study may provide guidance to inform policy, practice, research and development of curriculum and continuous professional development resources...
December 13, 2018: BMC Family Practice
Mélanie Tremblay, Catherine Vallée, Maude Carignan, Véronique Provencher, Nathalie Delli-Colli, Valérie Poulin, Anik Giguère, Emmanuelle Careau, Dominique Giroux
The decision on patients' competency to manage their affairs and take care of themselves requires a rigorous evaluation process and consistency among practice settings. Research indicates there is a lack of resources to guide healthcare and social service professionals in the interprofessional decision-making process that such an evaluation requires. A web-based tool, the Competency Assessment Tool (CAT), was designed to assist professionals in that process. The authors conducted a usability study with a beta version of the CAT...
December 13, 2018: Informatics for Health & Social Care
Louise Freebairn, Jo-An Atkinson, Paul M Kelly, Geoff McDonnell, Lucie Rychetnik
BACKGROUND: Systems science methods such as dynamic simulation modelling are well suited to address questions about public health policy as they consider the complexity, context and dynamic nature of system-wide behaviours. Advances in technology have led to increased accessibility and interest in systems methods to address complex health policy issues. However, the involvement of policy decision makers in health-related simulation model development has been lacking. Where end-users have been included, there has been limited examination of their experience of the participatory modelling process and their views about the utility of the findings...
December 12, 2018: BMC Medical Informatics and Decision Making
Ibrahim M Chamseddine, Hermann B Frieboes, Michael Kokkolaras
Nanotherapy may constitute a promising approach to target tumors with anticancer drugs while minimizing systemic toxicity. Computational modeling can enable rapid evaluation of nanoparticle (NP) designs and numerical optimization. Here, an optimization study was performed using an existing tumor model to find NP size and ligand density that maximize tumoral NP accumulation while minimizing tumor size. Optimal NP avidity lies at lower bound of feasible values, suggesting reduced ligand density to prolong NP circulation...
December 11, 2018: Scientific Reports
Ankur Agrawal
BACKGROUND: SNOMED CT is a standardized and comprehensive clinical terminology that is used in Electronic Health Records to capture, store and access clinical data of patients. Studies have, however, shown that there are inconsistencies inherent in the modeling of concepts in SNOMED CT that can have an impact on its usage to record clinical data and in clinical decision-making tools. METHODS: An effective lexical approach to identifying inconsistencies with high likelihood in the structural modeling of the concepts of SNOMED CT is discussed and assessed...
December 12, 2018: BMC Medical Informatics and Decision Making
Dean F Sittig, Adam Wright, Enrico Coiera, Farah Magrabi, Raj Ratwani, David W Bates, Hardeep Singh
We identify and describe nine key, short-term, challenges to help healthcare organizations, health information technology developers, researchers, policymakers, and funders focus their efforts on health information technology-related patient safety. Categorized according to the stage of the health information technology lifecycle where they appear, these challenges relate to (1) developing models, methods, and tools to enable risk assessment; (2) developing standard user interface design features and functions; (3) ensuring the safety of software in an interfaced, network-enabled clinical environment; (4) implementing a method for unambiguous patient identification (1-4 Design and Development stage); (5) developing and implementing decision support which improves safety; (6) identifying practices to safely manage information technology system transitions (5 and 6 Implementation and Use stage); (7) developing real-time methods to enable automated surveillance and monitoring of system performance and safety; (8) establishing the cultural and legal framework/safe harbor to allow sharing information about hazards and adverse events; and (9) developing models and methods for consumers/patients to improve health information technology safety (7-9 Monitoring, Evaluation, and Optimization stage)...
December 11, 2018: Health Informatics Journal
Alex M Cressman, Derek R MacFadden, Amol A Verma, Fahad Razak, Nick Daneman
Background: Physicians face competing demands of maximizing pathogen coverage, while minimizing unnecessary use of broad-spectrum antibiotics when managing sepsis. We sought to identify physicians' perceived likelihood of coverage achieved by their usual empiric antibiotic regimen, along with minimum thresholds of coverage they would be willing to accept when managing these patients. Methods: We conducted a scenario-based survey of internal medicine physicians from across Canada using a 2 x 2 factorial design, varied by infection source (undifferentiated vs...
December 7, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Zhi Qu, Christian Krauth, Volker Eric Amelung, Alexander Kaltenborn, Jill Gwiasda, Lena Harries, Jan Beneke, Harald Schrem, Sebastian Liersch
As the gap between a shortage of organs and the immense demand for liver grafts persists, every available donor liver needs to be optimized for utility, urgency and equity. To overcome this challenge, decision modelling might allow us to gather evidence from previous studies as well as compare the costs and consequences of alternative options. For public health policy and clinical intervention assessment, it is a potentially powerful tool. The most commonly used types of decision analytical models include decision trees, the Markov model, microsimulation, discrete event simulation and the system dynamic model...
November 27, 2018: World Journal of Hepatology
Lorena Endara, Anne E Thessen, Heather A Cole, Ramona Walls, Georgios Gkoutos, Yujie Cao, Steven S Chong, Hong Cui
Background: When phenotypic characters are described in the literature, they may be constrained or clarified with additional information such as the location or degree of expression, these terms are called "modifiers". With effort underway to convert narrative character descriptions to computable data, ontologies for such modifiers are needed. Such ontologies can also be used to guide term usage in future publications. Spatial and method modifiers are the subjects of ontologies that already have been developed or are under development...
2018: Biodiversity Data Journal
Brittany A Borden, Paige Galecki, Rebecca Wellmann, Keith Danahey, Sang Mee Lee, Linda Patrick-Miller, Matthew J Sorrentino, Rita Nanda, Jay L Koyner, Tamar S Polonsky, Walter M Stadler, Cathleen Mulcahy, Robert T Kavitt, Mark J Ratain, David O Meltzer, Peter H O'Donnell
OBJECTIVE: The objective of this study was to study provider attitudes of and perceived barriers to the clinical use of pharmacogenomics before and during participation in an implementation program. PARTICIPANTS AND METHODS: From 2012 to 2017, providers were recruited. After completing semistructured interviews (SSIs) about pharmacogenomics, providers received training on and access to a clinical decision support tool housing patient-specific pharmacogenomic results...
December 6, 2018: Pharmacogenetics and Genomics
Suzanne S Sullivan, Sharon Hewner, Varun Chandola, Bonnie L Westra
BACKGROUND: Newer analytic approaches for developing predictive models provides a method of creating decision support to translate findings into practice. OBJECTIVES: To develop and validate a clinically interpretable predictive model for 12-month mortality risk among community-dwelling older adults. This is done by using routinely collected nursing assessment data to aide homecare nurses in identifying older adults who are at risk for decline, providing an opportunity to develop care plans that support patient and family goals for care...
December 6, 2018: Nursing Research
Aglae Sousa, Andrea A Cardoso, Monia Kayo, Guilherme Gregorio, Jair de Jesus Mari, Denise Razzouk
BACKGROUND: There is a scarcity of tested instruments for measuring mental health services and costs. The Client Sociodemographic Service Receipt Inventory (CSSRI) is the most used tool in economic evaluation in mental health in Europe; it was translated into five languages, and it was mainly used to evaluate deinstitutionalisation process in mental health system reform. AIMS OF THE STUDY: To translate and adapt to the Brazilian healthcare system, and to test its inter-rater reliability, validity and its feasibility in a deinstitutionalized sample of psychiatric hospital living in residential facilities...
September 1, 2018: Journal of Mental Health Policy and Economics
Carolyn M Kercsmar, Christine A Sorkness, Agustin Calatroni, Peter J Gergen, Gordon R Bloomberg, Rebecca S Gruchalla, Meyer Kattan, Andrew H Liu, George T O'Connor, Jacqueline A Pongracic, Stanley J Szefler, Stephen J Teach, Jeremy J Wildfire, Robert A Wood, Edward M Zoratti, William W Busse
BACKGROUND: Multi-center randomized controlled trials (RCTs) for asthma management that incorporate usual care regimens could benefit from standardized application of evidence-based guidelines. OBJECTIVE: To evaluate performance of a computerized decision support tool, Asthma Control Evaluation and Treatment (ACET) Program, to standardize usual care regimens for asthma management in RCTs. METHODS: Children and adolescents with persistent, uncontrolled asthma, living in urban census tracts were recruited into 3 multi-center RCTs (each with a usual care arm) between 2004 and 2014...
December 5, 2018: Journal of Allergy and Clinical Immunology
Salil V Deo, Sajjad Raza, Salah E Altarabsheh, Vaishali S Deo, Yakov E Elgudin, Shayan Marsia, Stephen Mitchell, Carolyn Chang, Ankur Kalra, Sahil Khera, Dhaval Kolte, Marco Costa, Daniel Simon, Alan H Markowitz, Soon J Park, Joseph F Sabik
BACKGROUND: Re-admission is an important source of patient dissatisfaction and increased hospital costs. A simple calculator to determine the probability of re-admission may help guide patient dismissal planning. METHODS: Using the national readmissions database (NRD), we identified admissions for isolated primary coronary artery bypass (CABG) and stratified them according to 30-day readmission. Including pre, intra and postoperative variables, we prepared a logistic regression model to determine the probability for re-admission...
November 29, 2018: Heart, Lung & Circulation
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"