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https://www.readbyqxmd.com/read/28635983/risk-factors-for-re-excision-following-breast-conserving-surgery
#1
Kimberly Rodriguez, Gayle G Wilkins, Patricia Newcomb, Patricia A Gwirtz, Robin Skrine
PURPOSE/OBJECTIVES: To identify previously unstudied factors predicting re-excision following breast-conserving surgery (BCS) and to assess the feasibility of obtaining data about breast density for predictive modeling.
. DESIGN: Retrospective secondary data analysis.
. SETTING: Data were obtained from the cancer registry and electronic health records (EHRs) at Texas Health Harris Methodist Hospital, a large, urban, private, nonprofit hospital in North Texas...
May 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28634427/leveraging-food-and-drug-administration-adverse-event-reports-for-the-automated-monitoring-of-electronic-health-records-in-a-pediatric-hospital
#2
Huaxiu Tang, Imre Solti, Eric Kirkendall, Haijun Zhai, Todd Lingren, Jaroslaw Meller, Yizhao Ni
The objective of this study was to determine whether the Food and Drug Administration's Adverse Event Reporting System (FAERS) data set could serve as the basis of automated electronic health record (EHR) monitoring for the adverse drug reaction (ADR) subset of adverse drug events. We retrospectively collected EHR entries for 71 909 pediatric inpatient visits at Cincinnati Children's Hospital Medical Center. Natural language processing (NLP) techniques were used to identify positive diseases/disorders and signs/symptoms (DDSSs) from the patients' clinical narratives...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28627287/utilizing-the-electronic-health-record-to-improve-advance-care-planning-a-systematic-review
#3
Michael Todd Huber, Janelle Deneen Highland, Venkatesan Ram Krishnamoorthi, Joyce Wing-Yi Tang
PURPOSE: Advance care planning may ensure care that is concordant with patient wishes. However, advance care plans are frequently absent when needed due to failure to engage patients in planning, inability to access prior documentation, or poor documentation quality. Interventions utilizing tools within the electronic health record (EHR) may address these barriers at the point of care. We aimed to identify EHR interventions previously utilized to improve advance care plans. METHODS: We systematically searched 7 databases for observational and experimental studies of EHR interventions associated with advance care plans...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28625502/a-computable-phenotype-improves-cohort-ascertainment-in-a-pediatric-pulmonary-hypertension-registry
#4
Alon Geva, Jessica L Gronsbell, Tianxi Cai, Tianrun Cai, Shawn N Murphy, Jessica C Lyons, Michelle M Heinz, Marc D Natter, Nandan Patibandla, Jonathan Bickel, Mary P Mullen, Kenneth D Mandl
OBJECTIVES: To compare registry and electronic health record (EHR) data mining approaches for cohort ascertainment in patients with pediatric pulmonary hypertension (PH) in an effort to overcome some of the limitations of registry enrollment alone in identifying patients with particular disease phenotypes. STUDY DESIGN: This study was a single-center retrospective analysis of EHR and registry data at Boston Children's Hospital. The local Informatics for Integrating Biology and the Bedside (i2b2) data warehouse was queried for billing codes, prescriptions, and narrative data related to pediatric PH...
June 15, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28624641/text-mining-applied-to-electronic-cardiovascular-procedure-reports-to-identify-patients-with-trileaflet-aortic-stenosis-and-coronary-artery-disease
#5
Aeron M Small, Daniel H Kiss, Yevgeny Zlatsin, David L Birtwell, Heather Williams, Marie A Guerraty, Yuchi Han, Saif Anwaruddin, John H Holmes, Julio A Chirinos, Robert L Wilensky, Jay Giri, Daniel J Rader
BACKGROUND: Interrogation of the electronic health record (EHR) using billing codes as a surrogate for diagnoses of interest has been widely used for clinical research. However, the accuracy of this methodology is variable, as it reflects billing codes rather than severity of disease, and depends on the disease and the accuracy of the coding practitioner. Systematic application of text mining to the EHR has had variable success for the detection of cardiovascular phenotypes. We hypothesize that the application of text mining algorithms to cardiovascular procedure reports may be a superior method to identify patients with cardiovascular conditions of interest...
June 14, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28624074/evaluating-quality-of-dental-care-among-patients-with-diabetes-adaptation-and-testing-of-a-dental-quality-measure-in-electronic-health-records
#6
Ana Neumann, Elsbeth Kalenderian, Rachel Ramoni, Alfa Yansane, Bunmi Tokede, Jini Etoule, Ram Vaderhobli, Kristen Simmons, Joshua Even, Joanna Mullins, Shwetha Kumar, Suhasini Bangar, Krishna Kookal, Joel White, Muhammad Walji
BACKGROUND: Patients with diabetes are at increased risk of developing oral complications, and annual dental examinations are an endorsed preventive strategy. The authors evaluated the feasibility and validity of implementing an automated electronic health record (EHR)-based dental quality measure to determine whether patients with diabetes received such evaluations. METHODS: The authors selected a Dental Quality Alliance measure developed for claims data and adapted the specifications for EHRs...
June 14, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28620094/an-interrupted-time-series-analysis-to-determine-the-effect-of-an-electronic-health-record-based-intervention-on-appropriate-screening-for-type-2-diabetes-in-urban-primary-care-clinics-in-new-york-city
#7
Jeanine B Albu, Nancy Sohler, Rui Li, Xuan Li, Edwin Young, Edward W Gregg, Dennis Ross-Degnan
OBJECTIVE: To determine the impact of a health system-wide primary care diabetes management system, which included targeted guidelines for type 2 diabetes (T2DM) and prediabetes (dysglycemia) screening, on detection of previously undiagnosed dysglycemia cases. RESEARCH DESIGN AND METHODS: Intervention included electronic health record (EHR)-based decision support and standardized providers and staff training for using the American Diabetes Association guidelines for dysglycemia screening...
June 15, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28614166/seven-years-after-meaningful-use-physicians-and-nurses-experiences-with-electronic-health-records
#8
Cheryl Rathert, Tracy H Porter, Jessica N Mittler, Michelle Fleig-Palmer
Although the federal government's Meaningful Use electronic health record (EHR) implementation program resulted in some successes, there have been many challenges. The purpose of this study was to obtain detailed empirical data to better understand physicians' and nurses' experiences with EHRs. We conducted in-depth interviews with 30 physicians and nurses from two large health systems that were focused on attaining Stage 3 Meaningful Use criteria. Thematic framework analysis identified themes related to perceived benefits and challenges with EHR use...
June 13, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28608510/agreement-and-validity-of-electronic-health-record-prescribing-data-relative-to-pharmacy-claims-data-a-validation-study-from-a-us-electronic-health-record-database
#9
Christopher G Rowan, James Flory, Tobias Gerhard, John K Cuddeback, Nikita Stempniewicz, James D Lewis, Sean Hennessy
BACKGROUND: Granular clinical and laboratory data available in electronic health record (EHR) databases provide researchers the opportunity to conduct investigations that would not be possible in insurance claims databases; however, for pharmacoepidemiology studies, accurate classification of medication exposure is critical. OBJECTIVE: The aim of this study was to evaluate the validity of classifying medication exposure using EHR prescribing (EHR-Rx) data. METHODS: We conducted a retrospective cohort study among patients with linked claims and EHR data in OptumLabs™ Data Warehouse...
June 12, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#10
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28602423/a-fast-and-accurate-algorithm-to-test-for-binary-phenotypes-and-its-application-to-phewas
#11
Rounak Dey, Ellen M Schmidt, Goncalo R Abecasis, Seunggeun Lee
The availability of electronic health record (EHR)-based phenotypes allows for genome-wide association analyses in thousands of traits and has great potential to enable identification of genetic variants associated with clinical phenotypes. We can interpret the phenome-wide association study (PheWAS) result for a single genetic variant by observing its association across a landscape of phenotypes. Because a PheWAS can test thousands of binary phenotypes, and most of them have unbalanced or often extremely unbalanced case-control ratios (1:10 or 1:600, respectively), existing methods cannot provide an accurate and scalable way to test for associations...
June 2, 2017: American Journal of Human Genetics
https://www.readbyqxmd.com/read/28599812/making-electronic-health-records-support-quality-management-a-narrative-review
#12
REVIEW
Peter Triantafillou
BACKGROUND: Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). OBJECTIVE: Undertake a narrative review of existing studies in order to identify and discuss the factors conducive to making EHR support three dimensions of QM: clinical outcomes, managerial monitoring and cost-effectiveness...
August 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28598890/comparing-population-based-risk-stratification-model-performance-using-demographic-diagnosis-and-medication-data-extracted-from-outpatient-electronic-health-records-versus-administrative-claims
#13
Hadi Kharrazi, Winnie Chi, Hsien-Yen Chang, Thomas M Richards, Jason M Gallagher, Susan M Knudson, Jonathan P Weiner
BACKGROUND: There is an increasing demand for electronic health record (EHR)-based risk stratification and predictive modeling tools at the population level. This trend is partly due to increased value-based payment policies and the increasing availability of EHRs at the provider level. Risk stratification models, however, have been traditionally derived from claims or encounter systems. This study evaluates the challenges and opportunities of using EHR data instead of or in addition to administrative claims for risk stratification...
June 8, 2017: Medical Care
https://www.readbyqxmd.com/read/28595766/improving-universal-pediatric-lipid-screening
#14
Kathleen DeSantes, Ann Dodge, Jens Eickhoff, Amy L Peterson
OBJECTIVE: To evaluate whether the release of national guidelines, electronic health record (EHR) modifications, and educational initiatives correlated with changes in pediatricians' universal lipid screening practices. STUDY DESIGN: Retrospective review of EHRs in an academic general pediatric practice was performed to measure the prevalence of order placement. A child was "screened" if an order was placed during a well-visit between 9 and 21 years of age. The prevalence of order placement for lipid screens on 22 374 patients from January 2010 to December 2015 was analyzed for date of order and patient age, then compared with timing of guidelines, local educational initiatives, and EHR modifications...
June 5, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28595032/comparing-prevalence-estimates-from-population-based-surveys-to-inform-surveillance-using-electronic-health-records
#15
Kathleen S Tatem, Matthew L Romo, Katharine H McVeigh, Pui Ying Chan, Elizabeth Lurie-Moroni, Lorna E Thorpe, Sharon E Perlman
INTRODUCTION: Electronic health record (EHR) systems provide an opportunity to use a novel data source for population health surveillance. Validation studies that compare prevalence estimates from EHRs and surveys most often use difference testing, which can, because of large sample sizes, lead to detection of significant differences that are not meaningful. We explored a novel application of the two one-sided t test (TOST) to assess the equivalence of prevalence estimates in 2 population-based surveys to inform margin selection for validating EHR-based surveillance prevalence estimates derived from large samples...
June 8, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28593116/bridging-the-gap-between-clinical-practice-and-public-health-using-ehr-data-to-assess-trends-in-the-seasonality-of-blood-pressure-control
#16
Aurora O Amoah, Sonia Y Angell, Hannah Byrnes-Enoch, Sam Amirfar, Phoenix Maa, Jason J Wang
Electronic health records (EHRs) provide timely access to millions of patient data records while limiting errors associated with manual data extraction. To demonstrate these advantages of EHRs to public health practice, we examine the ability of a EHR calculated blood-pressure (BP) measure to replicate seasonal variation as reported by prior studies that used manual data extraction. Our sample included 609 primary-care practices in New York City. BP control among hypertensives was defined as systolic blood pressure of 140 or less and diastolic blood pressure of 90 or less (BP < 140/90 mm Hg)...
June 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28589269/improving-std-screening-rates-on-a-university-campus
#17
Amanda Myers, Sherrie P McCaskill, Kathryn VanRavenstein
Gonorrhea and chlamydia infections have a high incidence among young adults. To increase screening rates among individuals aged 25 years of age and younger on a university campus, this quality improvement project was implemented to improve providers' knowledge of CDC guidelines through education. Education was provided to providers and staff members at a health clinic on a private residential university campus through informational sessions to increase knowledge of guideline-directed screening for gonorrhea and chlamydia...
June 6, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28588141/tetragonal-ch3nh3pbi3-is-ferroelectric
#18
Yevgeny Rakita, Omri Bar-Elli, Elena Meirzadeh, Hadar Kaslasi, Yagel Peleg, Gary Hodes, Igor Lubomirsky, Dan Oron, David Ehre, David Cahen
Halide perovskite (HaP) semiconductors are revolutionizing photovoltaic (PV) solar energy conversion by showing remarkable performance of solar cells made with HaPs, especially tetragonal methylammonium lead triiodide (MAPbI3). In particular, the low voltage loss of these cells implies a remarkably low recombination rate of photogenerated carriers. It was suggested that low recombination can be due to the spatial separation of electrons and holes, a possibility if MAPbI3 is a semiconducting ferroelectric, which, however, requires clear experimental evidence...
June 6, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28587608/integrating-clinical-decision-support-systems-for-pharmacogenomic-testing-into-clinical-routine-a-scoping-review-of-designs-of-user-system-interactions-in-recent-system-development
#19
Marc Hinderer, Martin Boeker, Sebastian A Wagner, Martin Lablans, Stephanie Newe, Jan L Hülsemann, Michael Neumaier, Harald Binder, Harald Renz, Till Acker, Hans-Ulrich Prokosch, Martin Sedlmayr
BACKGROUND: Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS...
June 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28586621/evaluating-the-use-of-electronic-health-records-for-type-2-diabetes-surveillance-in-2-california-counties-2010-2014
#20
Maxwell J Richardson, Stephen K Van Den Eeden, Eric Roberts, Assiamira Ferrara, Susan Paulukonis, Paul English
OBJECTIVES: Electronic health records (EHRs) and electronic laboratory records (ELRs) are increasingly seen as a rich source of data for performing public health surveillance activities and monitoring community health status. Their potential for surveillance of chronic illness, however, may be underused. Our objectives were to (1) evaluate the use of EHRs and ELRs for diabetes surveillance in 2 California counties and (2) examine disparities in diabetes prevalence by geography, income, and race/ethnicity...
January 1, 2017: Public Health Reports
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