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https://www.readbyqxmd.com/read/28329300/personalising-the-decision-for-prolonged-dual-antiplatelet-therapy-development-validation-and-potential-impact-of-prognostic-models-for-cardiovascular-events-and-bleeding-in-myocardial-infarction-survivors
#1
Laura Pasea, Sheng-Chia Chung, Mar Pujades-Rodriguez, Alireza Moayyeri, Spiros Denaxas, Keith A A Fox, Lars Wallentin, Stuart J Pocock, Adam Timmis, Amitava Banerjee, Riyaz Patel, Harry Hemingway
Aims: The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results: Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n = 12 694 patients) and validated (n = 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28328647/pressure-injury-in-a-community-population-a-descriptive-study
#2
Lisa Q Corbett, Marjorie Funk, Gilbert Fortunato, David M OʼSullivan
PURPOSE: The purpose of this study was to describe present-on-admission pressure injuries (POA-PIs) in community-dwelling adults admitted to acute care. The specific aims of the study were to (1) measure the prevalence of POA-PIs during a 1-year period; (2) determine prehospital location of patients with POA-PIs; and (3) describe demographics, pressure injury (PI) characteristics, risk factors, and posthospital outcome of community-dwelling adults with PIs admitted to hospital. DESIGN: Retrospective descriptive study...
March 21, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28324321/structured-data-entry-in-the-electronic-medical-record-perspectives-of-pediatric-specialty-physicians-and-surgeons
#3
Ruth A Bush, Cynthia Kuelbs, Julie Ryu, Wen Jiang, George Chiang
The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28323609/language-structure-and-reuse-in-the-electronic-health-record
#4
Angus Roberts
Medical language is at the heart of the electronic health record (EHR), with up to 70 percent of the information in that record being recorded in the natural language, free-text portion. In moving from paper medical records to EHRs, we have opened up opportunities for the reuse of this clinical information through automated search and analysis. Natural language, however, is challenging for computational methods. This paper examines the tension between the nuanced, qualitative nature of medical language and the logical, structured nature of computation as well as the way in which these have interacted with each other through the medium of the EHR...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323114/physician-activity-during-outpatient-visits-and-subjective-workload
#5
Alan Calvitti, Harry Hochheiser, Shazia Ashfaq, Kristin Bell, Yunan Chen, Robert El Kareh, Mark T Gabuzda, Lin Liu, Sara Mortensen, Braj Pandey, Steven Rick, Richard L Street, Nadir Weibel, Charlene Weir, Zia Agha
We describe methods for capturing and analyzing EHR use and clinical workflow of physicians during outpatient encounters and relating activity to physicians' self-reported workload. We collected temporally-resolved activity data including audio, video, EHR activity, and eye-gaze along with post-visit assessments of workload. These data are then analyzed through a combination of manual content analysis and computational techniques to temporally align streams, providing a range of process measures of EHR usage, clinical workflow, and physician-patient communication...
March 17, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28323112/strategies-for-handling-missing-clinical-data-for-automated-surgical-site-infection-detection-from-the-electronic-health-record
#6
Zhen Hu, Genevieve B Melton, Elliot G Arsoniadis, Yan Wang, Mary R Kwaan, Gyorgy J Simon
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for analyzing EHR data is limited and specific efficacy for postoperative complication detection is unclear. Several data imputation methods were used to develop data models for automated detection of three types (i.e., superficial, deep, and organ space) of surgical site infection (SSI) and overall SSI using American College of Surgeons National Surgical Quality Improvement Project (NSQIP) Registry 30-day SSI occurrence data as a reference standard...
March 16, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28322657/data-quality-in-electronic-health-records-research
#7
Shelli L Feder
The proliferation of the electronic health record (EHR) has led to increasing interest and opportunities for nurse scientists to use EHR data in a variety of research designs. However, methodological problems pertaining to data quality may arise when EHR data are used for nonclinical purposes. Therefore, this article describes common domains of data quality and approaches for quality appraisal in EHR research. Common data quality domains include data accuracy, completeness, consistency, credibility, and timeliness...
January 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28321550/ethical-implications-of-the-electronic-health-record-in-the-service-of-the-patient
#8
Lois Snyder Sulmasy, Ana María López, Carrie A Horwitch
Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met...
March 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28318337/the-association-of-timing-of-disease-modifying-drug-initiation-and-relapse-in-patients-with-multiple-sclerosis-using-electronic-health-records
#9
Frank A Corvino, David Oliveri, Amy L Phillips
OBJECTIVE: A large, US de-identified electronic health record (EHR) database (Optum-Humedica de-identified Electronic Health Record dataset) was used to evaluate whether earlier disease-modifying drug (DMD) treatment initiation was associated with improved outcomes in MS. METHODS: Newly diagnosed patients from 1/1/2008-8/30/2014 (International Classification of Diseases, Ninth Revision, Clinical Modification code: 340.xx; first MS diagnosis = index date) with healthcare activity 1 year pre- and 2-years post-index, and who initiated DMD treatment during the 2-year follow-up period, were included...
March 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28316887/comparison-of-methods-of-alert-acknowledgement-by-critical-care-clinicians-in-the-icu-setting
#10
Andrew M Harrison, Charat Thongprayoon, Christopher A Aakre, Jack Y Jeng, Mikhail A Dziadzko, Ognjen Gajic, Brian W Pickering, Vitaly Herasevich
BACKGROUND: Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. OBJECTIVE: To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system...
2017: PeerJ
https://www.readbyqxmd.com/read/28316874/computational-drug-repositioning-using-continuous-self-controlled-case-series
#11
Zhaobin Kuang, James Thomson, Michael Caldwell, Peggy Peissig, Ron Stewart, David Page
Computational Drug Repositioning (CDR) is the task of discovering potential new indications for existing drugs by mining large-scale heterogeneous drug-related data sources. Leveraging the patient-level temporal ordering information between numeric physiological measurements and various drug prescriptions provided in Electronic Health Records (EHRs), we propose a Continuous Self-controlled Case Series (CSCCS) model for CDR. As an initial evaluation, we look for drugs that can control Fasting Blood Glucose (FBG) level in our experiments...
August 2016: KDD: Proceedings
https://www.readbyqxmd.com/read/28315559/immunotherapy-toxicities-%C3%A2-a-new-electronic-documentation-template-to-improve-patient-care
#12
Elizabeth Reimschissel, Buenagracia Dela Cruz, Melissa Gonzalez, Joaquin Buitrago, Cary Goodman, Patricia A Johnston
BACKGROUND: Emerging immunotherapies are associated with numerous toxicities. Although traditional health records allow nurses to document system-based assessments, few offer immunotherapy-based documentation templates to assess and grade toxicities.
. OBJECTIVES: The aim of this article is to present the development of a standardized template for documenting genetically modified cellular product-related toxicities in an electronic health record (EHR).
. METHODS: Through interprofessional collaboration, a documentation template for genetically modified cellular product-related toxicities was developed in an EHR, allowing for standardized documentation, data reporting, and tracking of immune-related toxicities...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315538/self-administered-premedication-improving-taxane-chemotherapy-treatment%C3%A2
#13
Kristin Roper, Mary Lou Siefert, Frances Fuller, Diane Lucier, Donna L Berry
BACKGROUND: Patients receiving taxane therapy are at risk for hypersensitivity reactions without appropriate premedication management. Patients must understand the importance of taking premedications as prescribed to prevent reactions.
. OBJECTIVES: The objectives of this study were to implement and evaluate a multidisciplinary practice protocol comprised of standardized nursing documentation of premedication regimens, teaching, and patient adherence to at-home premedication in an electronic health record (EHR)...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315532/oral-chemotherapy-adherence-a-novel-nursing-intervention-using-an-electronic-health-record-workflow%C3%A2
#14
German Rodriguez, Minerva A Utate, George Joseph, Thelma St Victor
In the ambulatory care setting, chemotherapy regimens have become increasingly complex with the combination of induction treatments and oral medications. Nurses at one cancer center implemented an oral adherence tracking documentation system in the electronic health record (EHR). Oncology nurses assessed and monitored adherence to oral chemotherapy at each clinical encounter and during telephone calls and then documented findings in the EHR. After implementing this new standardized approach, adherence rates were captured as a metric for the organization...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28306135/how-common-are-pulmonary-and-hepatic-adverse-effects-in-older-adults-prescribed-nitrofurantoin
#15
Karin Claussen, Edward Stocks, Deepa Bhat, Jason Fish, Craig D Rubin
OBJECTIVES: To determine the frequency of serious pulmonary and hepatic adverse events (AEs) in persons aged 65 and older prescribed nitrofurantoin. DESIGN: Retrospective electronic health record (EHR) audit of nitrofurantoin prescriptions and associated AEs. SETTING: Urban academic medical center. PARTICIPANTS: All inpatients and outpatients aged 65 and older prescribed nitrofurantoin from January 1, 2010, to December 31, 2014...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28304268/empirical-evaluation-of-international-health-system-data-interoperability-mapping-the-wanda-horta-theory-to-the-omaha-system-ontology
#16
Lisiane Pruinelli, Amalia de Lucena, Karen A Monsen
Structured health care data has played a critical role in improving quality of care and achieving better patient outcomes. Despite increased use of terminology standards within the electronic health records (EHRs), there is a need to map multi-institutional data that represent patient observations to develop standardized information models. The purpose of this study was to conduct an empirical evaluation of the potential for international health system data interoperability with the Wanda Horta theory using the Omaha System ontology...
August 1, 2016: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28303255/active-use-of-electronic-health-records-ehrs-and-personal-health-records-phrs-for-epidemiologic-research-sample-representativeness-and-nonresponse-bias-in-a-study-of-women-during-pregnancy
#17
Julie K Bower, Claire E Bollinger, Randi E Foraker, Darryl B Hood, Abigail B Shoben, Albert M Lai
INTRODUCTION: With the growing use of electronic medical records, electronic health records (EHRs), and personal health records (PHRs) for health care delivery, new opportunities have arisen for population health researchers. Our objective was to characterize PHR users and examine sample representativeness and nonresponse bias in a study of pregnant women recruited via the PHR. DESIGN: Demographic characteristics were examined for PHR users and nonusers. Enrolled study participants (responders, n=187) were then compared with nonresponders and a representative sample of the target population...
2017: EGEMS
https://www.readbyqxmd.com/read/28295416/validating-harmful-alcohol-use-as-a-phenotype-for-genetic-discovery-using-phosphatidylethanol-and-a-polymorphism-in-adh1b
#18
Amy C Justice, Kathleen A McGinnis, Jan Tate, Ke Xu, William C Becker, Hongyu Zhao, Joel Gelernter, Henry R Kranzler
BACKGROUND: Although alcohol risk is heritable, few genetic risk variants have been identified. Longitudinal (EHR) data offer a largely untapped source of phenotypic information for genetic studies, but EHR-derived phenotypes for harmful alcohol exposure have yet to be validated. Using a variant of known effect, we used electronic health record (EHR) data to develop and validate a phenotype for harmful alcohol exposure that can be used to identify unknown genetic variants in large samples...
March 11, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28295260/hospital-readmission-and-social-risk-factors-identified-from-physician-notes
#19
Amol S Navathe, Feiran Zhong, Victor J Lei, Frank Y Chang, Margarita Sordo, Maxim Topaz, Shamkant B Navathe, Roberto A Rocha, Li Zhou
OBJECTIVE: To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions. STUDY SETTING: A multihospital academic health system in southeastern Massachusetts. STUDY DESIGN: An observational study of 49,319 patients with cardiovascular disease admitted from January 1, 2011, to December 31, 2013, using multivariable logistic regression to adjust for patient characteristics...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28293685/healthcare-team-perceptions-of-a-portal-for-parents-of-hospitalized-children-before-and-after-implementation
#20
Michelle M Kelly, Shannon M Dean, Pascale Carayon, Tosha B Wetterneck, Peter L T Hoonakker
BACKGROUND: Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs. OBJECTIVE: We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children...
March 15, 2017: Applied Clinical Informatics
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