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Decision Support Systems, Clinical

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https://www.readbyqxmd.com/read/28551002/development-of-a-computer-interpretable-clinical-guideline-model-for-decision-support-in-the-differential-diagnosis-of-hyponatremia
#1
Arturo González-Ferrer, M Ángel Valcárcel, Martín Cuesta, Joan Cháfer, Isabelle Runkle
INTRODUCTION: Hyponatremia is the most common type of electrolyte imbalance, occurring when serum sodium is below threshold levels, typically 135mmol/L. Electrolyte balance has been identified as one of the most challenging subjects for medical students, but also as one of the most relevant areas to learn about according to physicians and researchers. We present a computer-interpretable guideline (CIG) model that will be used for medical training to learn how to improve the diagnosis of hyponatremia applying an expert consensus document (ECDs)...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28549669/the-iscreen-electronic-diabetes-dashboard-a-tool-to-improve-knowledge-and-implementation-of-clinical-practice-guidelines
#2
Stacy Zahanova, Alexandra Tsouka, Mark R Palmert, Farid H Mahmud
OBJECTIVES: Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. METHODS: iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28546050/shared-decision-making-in-argentina-in-2017
#3
Mariela Barani, Karin Kopitowski, Carolina Carrara, María Victoria Ruiz Yanzi
Argentina is a high-middle income country located in Southern South America with an estimated population of 44 million inhabitants. The epidemiological profile of the population is characterised by an increase of non-communicable diseases. The health system is heterogeneous, fragmented and loosely integrated. There are no unified research agenda or government initiatives encouraging the implementation of and research on Shared Decision-Making (SDM). Progress has been made lately to respect patient autonomy through the enactment of the 'Patients' Rights Act', which expressly enshrines the right of patients to get information as a key element of decision-making...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28545598/indonesian-dengue-burden-estimates-review-of-evidence-by-an-expert-panel
#4
T Y M Wahyono, J Nealon, S Beucher, A Prayitno, A Moureau, S Nawawi, H Thabrany, M Nadjib
Routine, passive surveillance systems tend to underestimate the burden of communicable diseases such as dengue. When empirical methods are unavailable, complimentary opinion-based or extrapolative methods have been employed. Here, an expert Delphi panel estimated the proportion of dengue captured by the Indonesian surveillance system, and associated health system parameters. Following presentation of medical and epidemiological data and subsequent discussions, the panel made iterative estimates from which expansion factors (EF), the ratio of total:reported cases, were calculated...
May 26, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28544391/the-experience-sampling-method-as-an-mhealth-tool-to-support-self-monitoring-self-insight-and-personalized-health-care-in-clinical-practice
#5
Jim van Os, Simone Verhagen, Anne Marsman, Frenk Peeters, Maarten Bak, Machteld Marcelis, Marjan Drukker, Ulrich Reininghaus, Nele Jacobs, Tineke Lataster, Claudia Simons, Richel Lousberg, Sinan Gülöksüz, Carsten Leue, Peter C Groot, Wolfgang Viechtbauer, Philippe Delespaul
BACKGROUND: The experience sampling method (ESM) builds an intensive time series of experiences and contexts in the flow of daily life, typically consisting of around 70 reports, collected at 8-10 random time points per day over a period of up to 10 days. METHODS: With the advent of widespread smartphone use, ESM can be used in routine clinical practice. Multiple examples of ESM data collections across different patient groups and settings are shown and discussed, varying from an ESM evaluation of a 6-week randomized trial of mindfulness, to a twin study on emotion dynamics in daily life...
May 23, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28541749/multilevel-barriers-to-the-successful-implementation-of-lung-cancer-screening-why-does-it-have-to-be-so-hard
#6
Lisa Carter-Harris, Michael K Gould
The U.S. Preventive Services Task Force recommends lung cancer screening with low-dose computed tomography for long-term current and former smokers. However, lung cancer screening and its implementation is a complex issue. Screening has associated risks and potential harms that complicate the decision to screen for the patient, add to the already time-constrained clinical encounter for the provider, and present logistical and sociopolitical challenges in creating and implementing lung cancer screening programs for the health care system...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28538138/factors-leading-to-overutilisation-of-hospital-pathology-testing-the-junior-doctor
#7
William Ericksson, Janine Bothe, Heidi Cheung, Kate Zhang, Simone Kelly
Objective Pathology overutilisation is a significant issue affecting the quality and cost of health care. Because junior medical officers (JMOs) order most pathology tests in the hospital setting, the aim of the present study was to identify the main reasons for hospital pathology overutilisation from the perspective of the JMO.Methods A qualitative method, using focus group methodology, was undertaken. Sixteen JMOs from two hospitals participated in three focus groups. Data were analysed using thematic analysis...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28537945/making-sense-of-effective-partnerships-among-senior-leaders-in-the-national-health-service
#8
Mahima Mitra, Timothy Hoff, Paul Brankin, Sue Dopson
BACKGROUND: Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. PURPOSE: The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K. National Health Service. We explored (a) how they make sense of and act with respect to specific collaborative tensions in their interactions and (b) which aspects of their everyday leadership contexts heighten the probability for producing and resolving such tensions...
May 22, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28536089/smart-devices-for-older-adults-managing-chronic-disease-a-scoping-review
#9
REVIEW
Ben Yb Kim, Joon Lee
BACKGROUND: The emergence of smartphones and tablets featuring vastly advancing functionalities (eg, sensors, computing power, interactivity) has transformed the way mHealth interventions support chronic disease management for older adults. Baby boomers have begun to widely adopt smart devices and have expressed their desire to incorporate technologies into their chronic care. Although smart devices are actively used in research, little is known about the extent, characteristics, and range of smart device-based interventions...
May 23, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#10
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28532470/health-care-professionals-attitudes-towards-evidence-based-medicine-in-the-workers-compensation-setting-a-cohort-study
#11
Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock, Keri Lockwood, Ian D Cameron
BACKGROUND: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment...
May 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28532308/contributions-of-national-and-global-health-estimates-to-monitoring-health-related-sustainable-development-goals-in-thailand
#12
Kanitta Bundhamcharoen, Supon Limwattananon, Khanitta Kusreesakul, Viroj Tangcharoensathien
The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons...
January 2017: Global Health Action
https://www.readbyqxmd.com/read/28530527/health-care-costs-associated-with-addition-titration-and-switching-antihypertensive-medications-after-first-line-treatment-results-from-a-commercially-insured-sample
#13
Kalyani B Sonawane Deshmukh, Jingjing Qian, Kimberly B Garza, Bradley M Wright, Peng Zeng, Cecilia M Ganduglia Cazaban, Richard A Hansen
BACKGROUND: Treatment modifications are necessary for addressing issues related to efficacy and tolerance of first-line monotherapy, but they increase the economic burden on patients and their health plans. Understanding the differences in costs between alternative treatment modification strategies, if any, can serve as a guideline for clinical decision making and for designing cost-containment strategies. OBJECTIVE: To compare the health care utilization costs between (a) addition (i...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#14
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529124/shared-decision-making-in-spain-supportive-policies-and-research-initiatives-trends-and-directions-for-future
#15
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Pablo Alonso-Coello, Carola Orrego, Pedro Serrano-Aguilar
Patients' rights to autonomy, information and participation in their own health care are recognized in the Spanish legal system from the early 2000's. Public institutions have progressively launched several initiatives to promote and improve patients' empowerment and self-care. However, the concept of Shared Decision Making (SDM), although embedded in the more general concept of "active/empowered patient", usually has not been specifically advocated as an essential requisite for improving the quality of health services, either in the legal normative or the existing educational proposals...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529123/implementing-shared-decision-making-in-denmark-first-steps-and-future-focus-areas
#16
Karina Dahl Steffensen, Vibe Hjelholt Baker, Mette Marianne Vinter
What about the political climate? Although there is no explicit description of patient involvement in Danish legislation, patient-centred care is on the political agenda in Denmark. It is integrated as one of eight new national indicators of quality in health care, as well as in the most recent national plan for cancer treatment. What about tools for patient decision support? Development of evidence-based patient decision aids (PDAs) are still at an early stage in Denmark, but recent national and private funding has helped push the field forward...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#17
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527638/shared-decision-making-in-australia-in-2017
#18
Lyndal Trevena, Heather L Shepherd, Carissa Bonner, Jesse Jansen, Anne E Cust, Julie Leask, Narelle Shadbolt, Chris Del Mar, Kirsten McCaffery, Tammy Hoffmann
Shared Decision Making (SDM) is now firmly established within national clinical standards for accrediting hospitals, day procedure services, public dental services and medical education in Australia, with plans to align general practice, aged care and disability service. Implementation of these standards and training of health professionals is a key challenge for the Australian health sector at this time. Consumer involvement in health research, policy and clinical service governance has also increased, with a major focus on encouraging patients to ask questions during their clinical care...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526944/ventilator-data-extraction-with-a-video-display-image-capture-and-processing-system
#19
David B Wax, Bryan Hill, Matthew A Levin
Medical hardware and software device interoperability standards are not uniform. The result of this lack of standardization is that information available on clinical devices may not be readily or freely available for import into other systems for research, decision support, or other purposes. We developed a novel system to import discrete data from an anesthesia machine ventilator by capturing images of the graphical display screen and using image processing to extract the data with off-the-shelf hardware and open-source software...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#20
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
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