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https://www.readbyqxmd.com/read/29780034/improving-predictive-asthma-algorithms-with-modelled-environment-data-for-scotland-an-observational-cohort-study-protocol
#1
Ireneous N Soyiri, Aziz Sheikh, Stefan Reis, Kimberly Kavanagh, Massimo Vieno, Tom Clemens, Edward J Carnell, Jiafeng Pan, Abby King, Rachel C Beck, Hester J T Ward, Chris Dibben, Chris Robertson, Colin R Simpson
INTRODUCTION: Asthma has a considerable, but potentially, avoidable burden on many populations globally. Scotland has some of the poorest health outcomes from asthma. Although ambient pollution, weather changes and sociodemographic factors have been associated with asthma attacks, it remains unclear whether modelled environment data and geospatial information can improve population-based asthma predictive algorithms. We aim to create the afferent loop of a national learning health system for asthma in Scotland...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29726357/using-big-data-analytics-to-advance-precision-radiation-oncology
#2
Todd R McNutt, Stanley H Benedict, Daniel A Low, Kevin Moore, Ilya Shpitser, Wei Jiang, Pranav Lakshminarayanan, Zhi Cheng, Peijin Han, Xuan Hui, Minoru Nakatsugawa, Junghoon Lee, Joseph A Moore, Scott P Robertson, Veeraj Shah, Russ Taylor, Harry Quon, John Wong, Theodore DeWeese
Big clinical data analytics as a primary component of precision medicine is discussed, identifying where these emerging tools fit in the spectrum of genomics and radiomics research. A learning health system (LHS) is conceptualized that uses clinically acquired data with machine learning to advance the initiatives of precision medicine. The LHS is comprehensive and can be used for clinical decision support, discovery, and hypothesis derivation. These developing uses can positively impact the ultimate management and therapeutic course for patients...
June 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29724445/advancing-continuous-predictive-analytics-monitoring-moving-from-implementation-to-clinical-action-in-a-learning-health-system
#3
REVIEW
Jessica Keim-Malpass, Rebecca R Kitzmiller, Angela Skeeles-Worley, Curt Lindberg, Matthew T Clark, Robert Tai, James Forrest Calland, Kevin Sullivan, J Randall Moorman, Ruth A Anderson
In the intensive care unit, clinicians monitor a diverse array of data inputs to detect early signs of impending clinical demise or improvement. Continuous predictive analytics monitoring synthesizes data from a variety of inputs into a risk estimate that clinicians can observe in a streaming environment. For this to be useful, clinicians must engage with the data in a way that makes sense for their clinical workflow in the context of a learning health system (LHS). This article describes the processes needed to evoke clinical action after initiation of continuous predictive analytics monitoring in an LHS...
June 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29717954/learning-health-systems-the-research-community-awareness-challenge
#4
Scott McLachlan, Kudakwashe Dube, Derek Buchanan, Stephen Lean, Owen Johnson, Henry Potts, Thomas Gallagher, William Marsh, Norman Fenton
No abstract text is available yet for this article.
March 27, 2018: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29688309/the-learning-health-system-trial-design-and-participant-consent-in-comparative-effectiveness-research
#5
Mark Webster, Ralph Stewart, Nic Aagaard, Colin McArthur
No abstract text is available yet for this article.
April 23, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29678076/learning-healthcare-systems-scaling-up-integrated-care-programs
#6
Violeta Gaveikaite, Dimitris Filos, Helen Schonenberg, Remco van der Heijden, Nicos Maglaveras, Ioanna Chouvarda
Current healthcare systems are struggling with rising costs and unbalanced quality of care. Integrated care (IC) is a worldwide trend in healthcare reforms designed to tackle these problems. ACT@Scale is a partnership of leading European regions, industry and academia which aims to identify, transfer and scale-up existing integrated healthcare practices. In this context, participating programs are applying iterative process improvement cycles using collaborative methodologies. The vision of learning health systems (LHS) is similar to IC, but it focuses on IT means as a change enabler for rapid and continuous knowledge integration into better outcomes...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29629986/inclusion-of-unstructured-clinical-text-improves-early-prediction-of-death-or-prolonged-icu-stay
#7
Gary E Weissman, Rebecca A Hubbard, Lyle H Ungar, Michael O Harhay, Casey S Greene, Blanca E Himes, Scott D Halpern
OBJECTIVES: Early prediction of undesired outcomes among newly hospitalized patients could improve patient triage and prompt conversations about patients' goals of care. We evaluated the performance of logistic regression, gradient boosting machine, random forest, and elastic net regression models, with and without unstructured clinical text data, to predict a binary composite outcome of in-hospital death or ICU length of stay greater than or equal to 7 days using data from the first 48 hours of hospitalization...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29610402/-a-guide-to-gutsy-living-patient-driven-development-of-a-pediatric-ostomy-toolkit
#8
Jennie G David, Alexander Jofriet, Michael Seid, Peter A Margolis
No abstract text is available yet for this article.
April 2, 2018: Pediatrics
https://www.readbyqxmd.com/read/29601298/sepsis-as-a-model-for-improving-diagnosis
#9
REVIEW
Mark L Graber, Monika Patel, Stephen Claypool
Diagnostic safety could theoretically be improved by high-level interventions, such as improving clinical reasoning or eliminating system-related defects in care, or by focusing more specifically on a single problem or disease. In this review, we consider how the timely diagnosis of sepsis has evolved and improved as an example of the disease-focused approach. This progress has involved clarifying and revising the definitions of sepsis, efforts to raise awareness, faster and more reliable laboratory tests and a host of practice-level improvements based on health services research findings and recommendations...
March 28, 2018: Diagnosis
https://www.readbyqxmd.com/read/29534339/update-on-the-health-services-research-doctoral-core-competencies
#10
James F Burgess, Nir Menachemi, Matthew L Maciejewski
OBJECTIVE: To present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. DATA SOURCES AND DATA COLLECTION: Core competencies were originally developed in 2005, updated (but unpublished) in 2008, modestly updated for a 2016 HSR workforce conference, and revised based on feedback from attendees. Additional feedback was obtained from doctoral program directors, employer/workforce experts and attendees of presentation on these competencies at the AcademyHealth's June 2017 Annual Research Meeting...
March 13, 2018: Health Services Research
https://www.readbyqxmd.com/read/29514814/approaching-quality-improvement-at-scale-a-learning-health-system-approach-in-kenya
#11
Grace Irimu, Morris Ogero, George Mbevi, Ambrose Agweyu, Samuel Akech, Thomas Julius, Rachel Nyamai, David Githang'a, Philip Ayieko, Mike English
No abstract text is available yet for this article.
March 7, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29507485/regional-process-redesign-of-lung-cancer-care-a-learning-health-system-pilot-project
#12
M Fung-Kee-Fung, D E Maziak, J R Pantarotto, J Smylie, L Taylor, T Timlin, T Cacciotti, P J Villeneuve, C Dennie, C Bornais, S Madore, J Aquino, P Wheatley-Price, R S Ozer, D J Stewart
Background: The Ottawa Hospital (toh) defined delay to timely lung cancer care as a system design problem. Recognizing the patient need for an integrated journey and the need for dynamic alignment of providers, toh used a learning health system (lhs) vision to redesign regional diagnostic processes. A lhs is driven by feedback utilizing operational and clinical information to drive system optimization and innovation. An essential component of a lhs is a collaborative platform that provides connectivity across silos, organizations, and professions...
February 2018: Current Oncology
https://www.readbyqxmd.com/read/29494320/reg-ent-within-the-learning-health-system
#13
Kayte Spector-Bagdady, Andrew G Shuman
Clinical data registries are perhaps one of the most powerful outcomes of electronic medical records, and their benefits are projected to redound to patients and clinicians across the nation. The American Academy of Otolaryngology-Head and Neck Surgery Foundation's Reg-ent fits within the conceptual framework of a learning health system. Because the data within this system are deidentified, research informed consent is not legally required. But ethical concerns remain regarding whether and how to best notify, and whether to obtain consent from, patients whose data are included...
March 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29472173/co-designing-a-collaborative-chronic-care-network-c3n-for-inflammatory-bowel-disease-development-of-methods
#14
Michael Seid, George Dellal, Laura E Peterson, Lloyd Provost, Peter A Gloor, David Livingstone Fore, Peter A Margolis
BACKGROUND: Our health care system fails to deliver necessary results, and incremental system improvements will not deliver needed change. Learning health systems (LHSs) are seen as a means to accelerate outcomes, improve care delivery, and further clinical research; yet, few such systems exist. We describe the process of codesigning, with all relevant stakeholders, an approach for creating a collaborative chronic care network (C3N), a peer-produced networked LHS. OBJECTIVE: The objective of this study was to report the methods used, with a diverse group of stakeholders, to translate the idea of a C3N to a set of actionable next steps...
February 22, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29457138/leveraging-the-learning-health-care-model-to-improve-equity-in-the-age-of-genomic-medicine
#15
Katherine D Blizinsky, Vence L Bonham
To fully achieve the goals of a genomics-enabled learning health care system, purposeful efforts to understand and reduce health disparities and improve equity of care are essential. This paper highlights three major challenges facing genomics-enabled learning health care systems, as they pertain to ancestrally diverse populations: inequality in the utility of genomic medicine; lack of access to pharmacogenomics in clinical care; and inadequate incorporation of social and environmental data into the electronic health care record (EHR)...
January 2018: Learning Health Systems
https://www.readbyqxmd.com/read/29446451/practical-data-collection-and-extraction-for-big-data-applications-in-radiotherapy
#16
Todd R McNutt, Michael Bowers, Sierra Cheng, Peijin Han, Xuan Hui, Joseph Moore, Scott Robertson, Charles Mayo, Ranh Voong, Harry Quon
The capture of high quality treatment and outcomes data is necessary in order to learn from our clinical experiences with big data analytics. In radiotherapy, there are several practical challenges to overcome. Practical aspects of data collection are discussed pointing to a need for a culture change in clinical practice to one that captures structured patient related data in routine care in a prospective manner. Radiation dosimetry and the contoured anatomy must also be captured routinely to represent the best estimate of delivered radiation...
February 15, 2018: Medical Physics
https://www.readbyqxmd.com/read/29422796/quality-indicators-in-inflammatory-bowel-disease
#17
REVIEW
Sameer K Berry, Gil Y Melmed
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic, debilitating, and expensive condition affecting millions of people globally. There is significant variation in the quality of care for patients with IBD across North America, Europe, and Asia; this variation suggests poor quality of care due to overuse, underuse, or misuse of health services and disparity of outcomes. Several initiatives have been developed to reduce variation in care delivery and improve processes of care, patient outcomes, and reduced healthcare costs...
January 2018: Intestinal Research
https://www.readbyqxmd.com/read/29370377/big-data-from-electronic-health-records-for-early-and-late-translational-cardiovascular-research-challenges-and-potential
#18
Harry Hemingway, Folkert W Asselbergs, John Danesh, Richard Dobson, Nikolaos Maniadakis, Aldo Maggioni, Ghislaine Jm van Thiel, Maureen Cronin, Gunnar Brobert, Panos Vardas, Stefan D Anker, Diederick E Grobbee, Spiros Denaxas
Aims: Cohorts of millions of people's health records, whole genome sequencing, imaging, sensor, societal and publicly available data present a rapidly expanding digital trace of health. We aimed to critically review, for the first time, the challenges and potential of big data across early and late stages of translational cardiovascular disease research. Methods and results: We sought exemplars based on literature reviews and expertise across the BigData@Heart Consortium...
August 29, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29212497/adverse-events-recording-in-electronic-health-record-systems-in-primary-care
#19
Sabine E M de Hoon, Karin Hek, Liset van Dijk, Robert A Verheij
BACKGROUND: Adequate record keeping of medication adverse events in electronic health records systems is important for patient safety. Events that remain unrecorded cannot be communicated from one health professional to another. In the absence of a gold standard, we investigate the variation between Dutch general practices in the extent to which they record medication adverse events. METHODS: Data were derived from electronic health records (EHR) of Dutch general practices participating in NIVEL Primary Care Database (NIVEL-PCD) in 2014, including 308 general practices with a total practice population of 1,256,049 listed patients...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29179288/public-spending-on-health-service-and-policy-research-in-canada-the-united-kingdom-and-the-united-states-a-modest-proposal
#20
Vidhi Thakkar, Terrence Sullivan
Health services and policy research (HSPR) represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems...
April 10, 2017: International Journal of Health Policy and Management
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