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Decision Support Systems, Clinical

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https://www.readbyqxmd.com/read/28817861/population-health-management-and-cancer-screening
#1
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817655/assessing-experience-in-the-deliberate-practice-of-running-using-a-fuzzy-decision-support-system
#2
Maria Isabel Roveri, Edison de Jesus Manoel, Andrea Naomi Onodera, Neli R S Ortega, Vitor Daniel Tessutti, Emerson Vilela, Nelson Evêncio, Isabel C N Sacco
The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches' knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time...
2017: PloS One
https://www.readbyqxmd.com/read/28816912/distance-learning-adhd-quality-improvement-in-primary-care-a-cluster-randomized-trial
#3
Alexander G Fiks, Stephanie L Mayne, Jeremy J Michel, Jeffrey Miller, Manju Abraham, Andrew Suh, Abbas F Jawad, James P Guevara, Robert W Grundmeier, Nathan J Blum, Thomas J Power
OBJECTIVE: To evaluate a distance-learning, quality improvement intervention to improve pediatric primary care provider use of attention-deficit/hyperactivity disorder (ADHD) rating scales. METHODS: Primary care practices were cluster randomized to a 3-part distance-learning, quality improvement intervention (web-based education, collaborative consultation with ADHD experts, and performance feedback reports/calls), qualifying for Maintenance of Certification (MOC) Part IV credit, or wait-list control...
August 9, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28815153/high-risk-drug-drug-interactions-between-clinical-practice-guidelines-for-management-of-chronic-conditions
#4
Geoffrey J Tso, Samson W Tu, Mark A Musen, Mary K Goldstein
Clinicians and clinical decision-support systems often follow pharmacotherapy recommendations for patients based on clinical practice guidelines (CPGs). In multimorbid patients, these recommendations can potentially have clinically significant drug-drug interactions (DDIs). In this study, we describe and validate a method for programmatically detecting DDIs among CPG recommendations. The system extracts pharmacotherapy intervention recommendations from narrative CPGs, normalizes the terms, creates a mapping of drugs and drug classes, and then identifies occurrences of DDIs between CPG pairs...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815151/eye-tracking-for-clinical-decision-support-a-method-to-capture-automatically-what-physicians-are-viewing-in-the-emr
#5
Andrew J King, Harry Hochheiser, Shyam Visweswaran, Gilles Clermont, Gregory F Cooper
Eye-tracking is a valuable research tool that is used in laboratory and limited field environments. We take steps toward developing methods that enable widespread adoption of eye-tracking and its real-time application in clinical decision support. Eye-tracking will enhance awareness and enable intelligent views, more precise alerts, and other forms of decision support in the Electronic Medical Record (EMR). We evaluated a low-cost eye-tracking device and found the device's accuracy to be non-inferior to a more expensive device...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815144/a-clinical-decision-support-system-for-monitoring-post-colonoscopy-patient-follow-up-and-scheduling
#6
Roxanne Wadia, Mark Shifman, Forrest L Levin, Luis Marenco, Cynthia A Brandt, Kei-Hoi Cheung, Tamar Taddei, Michael Krauthammer
This paper describes a natural language processing (NLP)-based clinical decision support (CDS) system that is geared towards colon cancer care coordinators as the end users. The system is implemented using a metadata- driven Structured Query Language (SQL) function (discriminant function). For our pilot study, we have developed a training corpus consisting of 2,085 pathology reports from the VA Connecticut Health Care System (VACHS). We categorized reports as "actionable"- requiring close follow up, or "non-actionable"- requiring standard or no follow up...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815136/design-recommendations-for-pharmacogenomics-clinical-decision-support-systems
#7
Maher Khelifi, Peter Tarczy-Hornoch, Emily B Devine, Wanda Pratt
The use of pharmacogenomics (PGx) in clinical practice still faces challenges to fully adopt genetic information in targeting drug therapy. To incorporate genetics into clinical practice, many support the use of Pharmacogenomics Clinical Decision Support Systems (PGx-CDS) for medication prescriptions. This support was fueled by new guidelines to incorporate genetics for optimizing drug dosage and reducing adverse events. In addition, the complexity of PGx led to exploring CDS outside the paradigm of the basic CDS tools embedded in commercial electronic health records...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815131/integrating-medication-alert-data-into-a-clinical-data-repository-to-enable-retrospective-study-of-drug-interaction-alerts-in-clinical-practice
#8
Mei Liu, Brittany L Melton, Gregory Ator, Lemuel R Waitman
Current clinical data repositories primarily extract data from multiple administrative and electronic medical record (EMR) data resources (e.g., hospital and physician billing records) containing specific patient-level data including demographics, medications, laboratory results, diagnoses, and procedure codes. It overlooks the importance of EMR system-level data (e.g., medication alerts that are routinely used by physicians, nurses, and pharmacists for decision support) for the surveillance of EMR decision support tools...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815127/a-knowledge-based-system-for-intelligent-support-in-pharmacogenomics-evidence-assessment-ontology-driven-evidence-representation-and-retrieval
#9
Chia-Ju Lee, Beth Devine, Peter Tarczy-Hornoch
Pharmacogenomics holds promise as a critical component of precision medicine. Yet, the use of pharmacogenomics in routine clinical care is minimal, partly due to the lack of efficient and effective use of existing evidence. This paper describes the design, development, implementation and evaluation of a knowledge-based system that fulfills three critical features: a) providing clinically relevant evidence, b) applying an evidence-based approach, and c) using semantically computable formalism, to facilitate efficient evidence assessment to support timely decisions on adoption of pharmacogenomics in clinical care...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28812013/intelligent-techniques-using-molecular-data-analysis-in-leukaemia-an-opportunity-for-personalized-medicine-support-system
#10
REVIEW
Haneen Banjar, David Adelson, Fred Brown, Naeem Chaudhri
The use of intelligent techniques in medicine has brought a ray of hope in terms of treating leukaemia patients. Personalized treatment uses patient's genetic profile to select a mode of treatment. This process makes use of molecular technology and machine learning, to determine the most suitable approach to treating a leukaemia patient. Until now, no reviews have been published from a computational perspective concerning the development of personalized medicine intelligent techniques for leukaemia patients using molecular data analysis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28807617/measurement-of-peripheral-venous-catheter-related-phlebitis-a-cross-sectional-study
#11
Katarina Göransson, Ulrika Förberg, Eva Johansson, Maria Unbeck
BACKGROUND: Many instruments for measurement of peripheral venous catheter (PVC)-related phlebitis are available, but no consensus exists on their applicability in clinical practice. This absence of consensus affects the ability to identify and compare proportions of PVCs causing phlebitis within and across hospitals as the range varies between 2% and 62% in previous studies. We hypothesised that the instruments' ability to identify phlebitis varies. The aim of this study is to illustrate the complexity of application of phlebitis instruments to a clinical dataset...
August 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28807317/validation-of-the-famacha%C3%A2-system-in-south-american-camelids
#12
Bobby E Storey, Lisa H Williamson, Sue B Howell, Thomas H Terrill, Roy Berghaus, Anand N Vidyashankar, Ray M Kaplan
Haemonchus contortus resistant to multiple anthelmintics threaten the viability of the small ruminant industry in areas where this parasite is prevalent. In response to this situation, the FAMACHA© system was developed and validated for use with small ruminants as a way to detect clinical anemia associated with haemonchosis. Given that H. contortus and multiple anthelmintic resistance is a similar problem in camelids, the FAMACHA© system might also provide the same benefits. To address this need, a validation study of the FAMACHA© system was conducted on 21 alpaca and llama farms over a 2-year period...
August 30, 2017: Veterinary Parasitology
https://www.readbyqxmd.com/read/28805695/infants-investigated-by-the-child-welfare-system-exploring-a-distinct-profile-of-risks-service-needs-and-referrals-for-support-in-ontario
#13
Joanne Filippelli, Barbara Fallon, Esme Fuller-Thomson, Nico Trocmé
The science of early childhood development underscores that maltreatment and other adversities experienced during infancy heightens the risk for poor developmental and socio-emotional outcomes. Referrals to supportive services by the child welfare system are particularly critical during infancy given the rapidity of brain development and infants' sensitivity to their environment. The main objectives of the current study are to: (1) examine age-specific differences in clinical and case characteristics; (2) determine the factors associated with the service referral decision involving infants; and (3) explore the types of services families have been referred to at the conclusion of a maltreatment-related investigation...
August 12, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#14
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28801393/protocol-for-the-mwellcare-trial-a-multicentre-cluster-randomised-12-month-controlled-trial-to-compare-the-effectiveness-of-mwellcare-an-mhealth-system-for-an-integrated-management-of-patients-with-hypertension-and-diabetes-versus-enhanced-usual-care-in-india
#15
Dilip Jha, Priti Gupta, Vamadevan S Ajay, Devraj Jindal, Pablo Perel, David Prieto-Merino, Pramod Jacob, Jonathan Nyong, Vidya Venugopal, Kavita Singh, Shifalika Goenka, Ambuj Roy, Nikhil Tandon, Vikram Patel, Dorairaj Prabhakaran
INTRODUCTION: Rising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system. METHODS AND ANALYSIS: mWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801207/crediblemeds-org-what-does-it-offer
#16
REVIEW
Raymond L Woosley, Kristin Black, C William Heise, Klaus Romero
Since the 1990s, when numerous non-cardiac drugs were first recognized to have the potential to prolong the QT interval and cause torsades de pointes (TdP), clinicians, drug regulators, drug developers, and clinical investigators have become aware of the complexities of assessing evidence and determining TdP causality for the many drugs being marketed or under development. To facilitate better understanding, the Arizona Center for Education and Research on Therapeutics, known as AZCERT, has developed the CredibleMeds...
August 1, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28801025/toward-an-mri-based-nomogram-for-the-prediction-of-transperineal-prostate-biopsy-outcome-a-physician-and-patient-decision-tool
#17
Su-Min Lee, Sidath H Liyanage, Wahyu Wulaningsih, Konrad Wolfe, Thomas Carr, Choudhry Younis, Mieke Van Hemelrijck, Rick Popert, Peter Acher
PURPOSE: To develop and internally validate a nomogram using biparametric magnetic resonance imaging (B-MRI)-derived variables for the prediction of prostate cancer at transperineal sector-guided prostate biopsy (TPSB). SUBJECTS/PATIENTS AND METHODS: Consecutive patients referred to our institution with raised prostate-specific antigen (PSA), abnormal prostate examination, or persistent suspicion of prostate cancer after previous transrectal biopsy between July 2012 and November 2015 were reviewed from a prospective database...
August 8, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28795172/change-point-detection-method-for-clinical-decision-support-system-rule-monitoring
#18
Siqi Liu, Adam Wright, Milos Hauskrecht
A clinical decision support system (CDSS) and its components can malfunction due to various reasons. Monitoring the system and detecting its malfunctions can help one to avoid any potential mistakes and associated costs. In this paper, we investigate the problem of detecting changes in the CDSS operation, in particular its monitoring and alerting subsystem, by monitoring its rule firing counts. The detection should be performed online, that is whenever a new datum arrives, we want to have a score indicating how likely there is a change in the system...
June 2017: Artif Intell Med (2017)
https://www.readbyqxmd.com/read/28793070/the-lawsuits-to-antineoplastic-drugs-the-tip-of-an-iceberg
#19
Thaís Jeronimo Vidal, Elaine Lazzaroni Moraes, Maely Peçanha Favero Retto, Mario Jorge Sobreira da Silva
The lawsuits with antineoplastic drugs generate high costs for governments and require careful analysis to ensure efficient and adequate health results. This study analyzed cases conducted by federal entities to a reference institute for the treatment of cancer for technical opinion. Data were collected from copies of the cases examined from July 1 to December 31, 2013. It was analyzed: therapeutic subgroups, presence in essential drug list, drug registry, off-label use, indications of clinical practice guidelines, drug incorporation in Brazilian Health System and estimated value of court cases...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28792514/network-analysis-for-science-and-technology-management-evidence-from-tuberculosis-research-in-fiocruz-brazil
#20
Bruna de Paula Fonseca E Fonseca, Marcus Vinicius Pereira da Silva, Kizi Mendonça de Araújo, Ricardo Barros Sampaio, Milton Ozório Moraes
Collaborative networks are of great value for science and technology (S&T) institutions as a way of sharing, generating and disseminating new knowledge that could ultimately lead to innovations. Driven by the need to assess the contribution and effectiveness of these networks in informing S&T management, we explored the evolution and dynamics of tuberculosis scientific networks involving the Oswaldo Cruz Foundation (Fiocruz), the major public health S&T Institution in Brazil. Social network analysis (SNA) was used to produce a 10-year (2005-2009, 2010-2014) retrospective longitudinal mapping of Brazilian tuberculosis research networks within the country and internationally, highlighting Fiocruz collaborations...
2017: PloS One
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