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Decision Support Systems, Clinical

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https://www.readbyqxmd.com/read/28227784/an-analytics-based-clinical-decision-support-system-for-cvd-risk-assessment-and-management
#1
Shreya Anand, Ravindra B Patil, P Krishnamoorthy, Shreya Anand, Ravindra B Patil, P Krishnamoorthy, Shreya Anand, Ravindra B Patil, P Krishnamoorthy
Cardiovascular disease (CVD) is a major cause of disability and premature death throughout the world. Acute coronary events and other cardiovascular events frequently occur suddenly, and are often fatal before medical care can be given. Risk factor modification can reduce clinical events and premature death in people with established cardiovascular disease as well as in those who are at high cardiovascular risk due to one or more risk factors. In this work, India specific World Health Organization-International Society of Hypertension (WHO-ISH) guidelines has been implemented to stratify the subjects by their risk profile...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227143/csdc-a-nationwide-screening-platform-for-stroke-control-and-prevention-in-china
#2
Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao, Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao, Dan Ye, Huajian Mao, Mei Li, Dongsheng Zhao, Jinghui Yu
As a leading cause of severe disability and death, stroke places an enormous burden on Chinese society. A nationwide stroke screening platform called CSDC (China Stoke Data Center) has been built to support the national stroke prevention program and stroke clinical research since 2011. This platform is composed of a data integration system and a big data analysis system. The data integration system is used to collect information on risk factors, diagnosis history, treatment, and sociodemographic characteristics and stroke patients' EMR...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227048/anticoagulation-manager-development-of-a-clinical-decision-support-mobile-application-for-management-of-anticoagulants
#3
Chih-Wen Cheng, Hang Wu, Pamela J Thompson, Julie R Taylor, Barbara A Zehnbauer, Karlyn K Wilson, May D Wang, Chih-Wen Cheng, Hang Wu, Pamela J Thompson, Julie R Taylor, Barbara A Zehnbauer, Karlyn K Wilson, May D Wang, Karlyn K Wilson, Pamela J Thompson, Barbara A Zehnbauer, Hang Wu, Julie R Taylor, Chih-Wen Cheng, May D Wang
Patients with certain clotting disorders or conditions have a greater risk of developing arterial or venous clots and downstream embolisms, strokes, and arterial insufficiency. These patients need prescription anticoagulant drugs to reduce the possibility of clot formation. However, historically, the clinical decision making workflow in determining the correct type and dosage of anticoagulant(s) is part science and part art. To address this problem, we developed Anticoagulation Manager, an intelligent clinical decision workflow management system on iOS-based mobile devices to help clinicians effectively choose the most appropriate and helpful follow-up clotting tests for patients with a common clotting profile...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227033/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#4
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Mohamed Rehman, Ali Jalali, Vinay Nadkanri, Dieter Bender, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225511/treatment-satisfaction-in-systemic-lupus-erythematosus-development-of-a-patient-reported-outcome-measure
#5
Susan D Mathias, Pamela Berry, Katie Pascoe, Jane de Vries, Anca D Askanase, Hilary H Colwell, David J Chang
OBJECTIVE: The aim of this study was to develop a patient-reported outcome measure specific for systemic lupus erythematosus (SLE) to assess patient satisfaction with treatment, treatment options, and medical care. METHODS: Patients with SLE were recruited from four US rheumatology practices. Concept elicitation interviews identified aspects that patients considered important and relevant regarding satisfaction with treatment and medical care. Concept elicitation interviews and clinical input were used to draft the Lupus Satisfaction Questionnaire (LSQ)...
March 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28224645/clinical-decision-support-systems-differ-in-their-ability-to-identify-clinically-relevant-drug-interactions-of-immunosuppressants-in-kidney-transplant-patients
#6
J Amkreutz, A Koch, L Buendgens, C Trautwein, A Eisert
WHAT IS KNOWN AND OBJECTIVE: In kidney transplant patients, clinically relevant drug-drug interactions (DDIs) with immunosuppressants potentially lead to serious adverse drug events (ADEs). The aim of this study was (i) to show that five clinical decision support systems (CDSSs) differ in their ability to identify clinically relevant potential DDIs (pDDIs) of immunosuppressants in kidney transplant patients and (ii) to compare CDSSs in terms of their ability to identify clinically relevant pDDIs in this context...
February 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28224029/designing-clinical-and-genetic-guidelines-of-colorectal-cancer-screening-as-an-effective-roadmap-for-risk-management
#7
Mohammad Reza Zali, Reza Safdari, Elham Maserat, Hamid Asadzadeh Aghdaei
AIM: We aimed to present clinical and genetic guidelines of colorectal cancer screening for risk assessment of populations at risk. BACKGROUND: National guidelines can be used as a guide for choosing the method of screening for each individual. These guidelines facilitate decision making and support the delivery of cancer screening service. METHODS: In the first step, a comparative study was performed by using secondary data extracted from the literature review...
December 2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#8
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28222381/domain-specific-and-domain-general-processes-underlying-metacognitive-judgments
#9
Lisa M Fitzgerald, Mahnaz Arvaneh, Paul M Dockree
Metacognition and self-awareness are commonly assumed to operate as global capacities. However, there have been few attempts to test this assumption across multiple cognitive domains and metacognitive evaluations. Here, we assessed the covariance between "online" metacognitive processes, as measured by decision confidence judgments in the domains of perception and memory, and error awareness in the domain of attention to action. Previous research investigating metacognition across task domains have not matched stimulus characteristics across tasks raising the possibility that any differences in metacognitive accuracy may be influenced by local task properties...
February 17, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28222088/gender-differences-in-bladder-cancer-treatment-decision-making
#10
Rachel A Pozzar, Donna L Berry
PURPOSE/OBJECTIVES: To explore gender differences in bladder cancer treatment decision making.
. RESEARCH APPROACH: Secondary qualitative analysis of interview transcripts.
. SETTING: One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
. PARTICIPANTS: As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews...
March 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28217876/identifying-primary-care-pathways-from%C3%A2-quality-of-care-to-outcomes-and-satisfaction-using-structural-equation-modeling
#11
Ignacio Ricci-Cabello, Sarah Stevens, Andrew R H Dalton, Robert I Griffiths, John L Campbell, Jose M Valderas
OBJECTIVE: To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. DATA SOURCES: A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. STUDY DESIGN: Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217433/visual-analogue-scales-vas-measuring-instruments-for-the-documentation-of-symptoms-and-therapy-monitoring-in-cases-of-allergic-rhinitis-in-everyday-health-care-position-paper-of-the-german-society-of-allergology-aeda-and-the-german-society-of-allergy-and-clinical
#12
Ludger Klimek, Karl-Christian Bergmann, Tilo Biedermann, Jean Bousquet, Peter Hellings, Kirsten Jung, Hans Merk, Heidi Olze, Wolfgang Schlenter, Philippe Stock, Johannes Ring, Martin Wagenmann, Wolfgang Wehrmann, Ralph Mösges, Oliver Pfaar
BACKROUND: Visual analogue scales (VAS) are psychometric measuring instruments designed to document the characteristics of disease-related symptom severity in individual patients and use this to achieve a rapid (statistically measurable and reproducible) classification of symptom severity and disease control. VAS can also be used in routine patient history taking and to monitor the course of a chronic disease such as allergic rhinitis (AR). More specifically, the VAS has been used to assess effectiveness of AR therapy in real life, both in intermittent and persistent disease...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/28212969/lessons-learned-when-introducing-pharmacogenomic-panel-testing-into-clinical-practice
#13
Marc B Rosenman, Brian Decker, Kenneth D Levy, Ann M Holmes, Victoria M Pratt, Michael T Eadon
OBJECTIVES: Implementing new programs to support precision medicine in clinical settings is a complex endeavor. We describe challenges and potential solutions based on the Indiana GENomics Implementation: an Opportunity for the Underserved (INGenious) program at Eskenazi Health-one of six sites supported by the Implementing GeNomics In pracTicE network grant of the National Institutes of Health/National Human Genome Research Institute. INGenious is an implementation of a panel of genomic tests...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28211064/selecting-postoperative-adjuvant-systemic-therapy-for-early-stage-breast-cancer-a-critical-assessment-of-commercially-available-gene-expression-assays
#14
REVIEW
David M Hyams, Eric Schuur, Javier Angel Aristizabal, Juan Enrique Bargallo Rocha, Cesar Cabello, Roberto Elizalde, Laura García-Estévez, Henry L Gomez, Artur Katz, Aníbal Nuñez De Pierro
Risk stratification of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of six multi-gene classifiers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test's analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.
February 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28207198/integrated-precision-medicine-the-role-of-electronic-health-records-in-delivering-personalized-treatment
#15
REVIEW
Amy Sitapati, Hyeoneui Kim, Barbara Berkovich, Rebecca Marmor, Siddharth Singh, Robert El-Kareh, Brian Clay, Lucila Ohno-Machado
Precision Medicine involves the delivery of a targeted, personalized treatment for a given patient. By harnessing the power of electronic health records (EHRs), we are increasingly able to practice precision medicine to improve patient outcomes. In this article, we introduce the scientific community at large to important building blocks for personalized treatment, such as terminology standards that are the foundation of the EHR and allow for exchange of health information across systems. We briefly review different types of clinical decision support (CDS) and present the current state of CDS, which is already improving the care patients receive with genetic profile-based tailored recommendations regarding diagnostic and treatment plans...
February 16, 2017: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/28203277/semantics-based-plausible-reasoning-to-extend-the-knowledge-coverage-of-medical-knowledge-bases-for-improved-clinical-decision-support
#16
Hossein Mohammadhassanzadeh, William Van Woensel, Samina Raza Abidi, Syed Sibte Raza Abidi
BACKGROUND: Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians' experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mechanisms apply patterns from human thought processes, such as generalization, similarity and interpolation, based on attributional, hierarchical, and relational knowledge...
2017: BioData Mining
https://www.readbyqxmd.com/read/28199357/home-detection-of-freezing-of-gait-using-support-vector-machines-through-a-single-waist-worn-triaxial-accelerometer
#17
Daniel Rodríguez-Martín, Albert Samà, Carlos Pérez-López, Andreu Català, Joan M Moreno Arostegui, Joan Cabestany, Àngels Bayés, Sheila Alcaine, Berta Mestre, Anna Prats, M Cruz Crespo, Timothy J Counihan, Patrick Browne, Leo R Quinlan, Gearóid ÓLaighin, Dean Sweeney, Hadas Lewy, Joseph Azuri, Gabriel Vainstein, Roberta Annicchiarico, Alberto Costa, Alejandro Rodríguez-Molinero
Among Parkinson's disease (PD) symptoms, freezing of gait (FoG) is one of the most debilitating. To assess FoG, current clinical practice mostly employs repeated evaluations over weeks and months based on questionnaires, which may not accurately map the severity of this symptom. The use of a non-invasive system to monitor the activities of daily living (ADL) and the PD symptoms experienced by patients throughout the day could provide a more accurate and objective evaluation of FoG in order to better understand the evolution of the disease and allow for a more informed decision-making process in making adjustments to the patient's treatment plan...
2017: PloS One
https://www.readbyqxmd.com/read/28197684/definition-of-variables-required-for-comprehensive-description-of-drug-dosage-and-clinical-pharmacokinetics
#18
Anna V Medem, Hanna M Seidling, Hans-Georg Eichler, Jens Kaltschmidt, Michael Metzner, Carina M Hubert, David Czock, Walter E Haefeli
PURPOSE: Electronic clinical decision support systems (CDSS) require drug information that can be processed by computers. The goal of this project was to determine and evaluate a compilation of variables that comprehensively capture the information contained in the summary of product characteristic (SmPC) and unequivocally describe the drug, its dosage options, and clinical pharmacokinetics. METHODS: An expert panel defined and structured a set of variables and drafted a guideline to extract and enter information on dosage and clinical pharmacokinetics from textual SmPCs as published by the European Medicines Agency (EMA)...
February 14, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28193619/improving-specialist-drug-prescribing-in-primary-care-using-task-and-error-analysis-an-observational-study
#19
Narinder Chana, Talya Porat, Cate Whittlesea, Brendan Delaney
BACKGROUND: Electronic prescribing has benefited from computerised clinical decision support systems (CDSSs); however, no published studies have evaluated the potential for a CDSS to support GPs in prescribing specialist drugs. AIM: To identify potential weaknesses and errors in the existing process of prescribing specialist drugs that could be addressed in the development of a CDSS. DESIGN AND SETTING: Semi-structured interviews with key informants followed by an observational study involving GPs in the UK...
February 13, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28192551/effectiveness-of-computer-automation-for-the-diagnosis-and-management-of-childhood-type-2-diabetes-a-randomized-clinical-trial
#20
Tamara S Hannon, Tamara M Dugan, Chandan K Saha, Steven J McKee, Stephen M Downs, Aaron E Carroll
Importance: Type 2 diabetes (T2D) is increasingly common in young individuals. Primary prevention and screening among children and adolescents who are at substantial risk for T2D are recommended, but implementation of T2D screening practices in the pediatric primary care setting is uncommon. Objective: To determine the feasibility and effectiveness of a computerized clinical decision support system to identify pediatric patients at high risk for T2D and to coordinate screening for and diagnosis of prediabetes and T2D...
February 13, 2017: JAMA Pediatrics
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