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JOURNAL ARTICLE
Aparna Priyanath Gupta, Dharmesh Patel, Ji Young Lee, Michelle Volpentesta, Michael Schachter, Stephen D Persell
OBJECTIVE: System-level safety measures do not exist to ensure that patients with iron deficiency anaemia (IDA) undergo proper diagnostic evaluations. We sought to determine if a set of EHR (electronic health record) tools and an expedited referral workflow increase short-term completion of bidirectional endoscopy in higher risk patients with IDA. MATERIALS AND METHODS: We conducted a pragmatic, cluster-randomised trial randomised by primary care physician (PCP) that included 16 PCPs and 316 patients with IDA...
April 15, 2024: BMJ Open Quality
#22
JOURNAL ARTICLE
Georgie May Massen, Philip W Stone, Harley H Y Kwok, Gisli Jenkins, Richard J Allen, Louise V Wain, Iain Stewart, Jennifer Kathleen Quint
BACKGROUND AND AIMS: Hypertension is a leading risk factor for cardiovascular disease. Electronic health records (EHRs) are routinely collected throughout a person's care, recording all aspects of health status, including current and past conditions, prescriptions and test results. EHRs can be used for epidemiological research. However, there are nuances in the way conditions are recorded using clinical coding; it is important to understand the methods which have been applied to define exposures, covariates and outcomes to enable interpretation of study findings...
April 15, 2024: Open Heart
#23
JOURNAL ARTICLE
Gondy Leroy, Jennifer G Andrews, Madison KeAlohi-Preece, Ajay Jaswani, Hyunju Song, Maureen Kelly Galindo, Sydney A Rice
OBJECTIVE: Machine learning (ML) is increasingly employed to diagnose medical conditions, with algorithms trained to assign a single label using a black-box approach. We created an ML approach using deep learning that generates outcomes that are transparent and in line with clinical, diagnostic rules. We demonstrate our approach for autism spectrum disorders (ASD), a neurodevelopmental condition with increasing prevalence. METHODS: We use unstructured data from the Centers for Disease Control and Prevention (CDC) surveillance records labeled by a CDC-trained clinician with ASD A1-3 and B1-4 criterion labels per sentence and with ASD cases labels per record using Diagnostic and Statistical Manual of Mental Disorders (DSM5) rules...
April 16, 2024: Journal of the American Medical Informatics Association: JAMIA
#24
JOURNAL ARTICLE
Karen Jeffrey, Lana Woolford, Rishma Maini, Siddharth Basetti, Ashleigh Batchelor, David Weatherill, Chris White, Vicky Hammersley, Tristan Millington, Calum Macdonald, Jennifer K Quint, Robin Kerr, Steven Kerr, Syed Ahmar Shah, Igor Rudan, Adeniyi Francis Fagbamigbe, Colin R Simpson, Srinivasa Vittal Katikireddi, Chris Robertson, Lewis Ritchie, Aziz Sheikh, Luke Daines
BACKGROUND: Long COVID is a debilitating multisystem condition. The objective of this study was to estimate the prevalence of long COVID in the adult population of Scotland, and to identify risk factors associated with its development. METHODS: In this national, retrospective, observational cohort study, we analysed electronic health records (EHRs) for all adults (≥18 years) registered with a general medical practice and resident in Scotland between March 1, 2020, and October 26, 2022 (98-99% of the population)...
May 2024: EClinicalMedicine
#25
JOURNAL ARTICLE
Tourkiah Alessa
AIM: This study explored physicians' and nurses' attitudes toward an electronic health record (EHR) system and examined the features and factors that clinicians associated with the implementation of EHR systems. METHODS: A self-administered anonymous questionnaire with high reliability and validity was adopted from existing research to gather clinicians' attitudes toward the EHR system implemented at King Khalid University Hospital, one of the biggest hospitals in Riyadh, Saudi Arabia...
March 2024: Curēus
#26
JOURNAL ARTICLE
Alison M Cogan, Pamela Roberts, Trudy Mallinson
Health services research (HSR) is a field of study that examines how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and health and well-being. HSR approaches can help build the occupational therapy evidence base, particularly in relation to population health. Data from electronic health record (EHR) systems provide a rich resource for applying HSR approaches to examine the value of occupational therapy services...
April 15, 2024: OTJR: Occupation, Participation and Health
#27
JOURNAL ARTICLE
Catarina Martins, Bernardo Neves, Andreia Sofia Teixeira, Miguel Froes, Pedro Sarmento, Jaime Machado, Carlos A Magalhães, Nuno A Silva, Mário J Silva, Francisca Leite
This study presents a workflow for identifying and characterizing patients with Heart Failure (HF) and multimorbidity utilizing data from Electronic Health Records. Multimorbidity, the co-occurrence of two or more chronic conditions, poses a significant challenge on healthcare systems. Nonetheless, understanding of patients with multimorbidity, including the most common disease interactions, risk factors, and treatment responses, remains limited, particularly for complex and heterogeneous conditions like HF...
April 15, 2024: BMC Medical Informatics and Decision Making
#28
JOURNAL ARTICLE
Jennifer Brandt, Edmond Ramly, S Sam Lim, Gaobin Bao, Monica L Messina, Megan E Piper, Christie M Bartels
OBJECTIVES: Quit Connect (QC), our specialty clinic smoking cessation intervention, supports clinic staff to check, advise, and connect willing patients to a state quit line or class. QC improved tobacco screening and quit line referrals 26-fold in a predominantly White academic healthcare system population. Implementing QC includes education, electronic health record (EHR) reminders, and periodic audit feedback. This study tested QC's feasibility and impact in a safety-net rheumatology clinic with a predominantly Black population...
April 15, 2024: Arthritis Care & Research
#29
JOURNAL ARTICLE
Khushboo Teotia, Yueran Jia, Naira Link Woite, Leo Anthony Celi, João Matos, Tristan Struja
OBJECTIVE: Health inequities can be influenced by demographic factors such as race and ethnicity, proficiency in English, and biological sex. Disparities may manifest as differential likelihood of testing which correlates directly with the likelihood of an intervention to address an abnormal finding. Our retrospective observational study evaluated the presence of variation in glucose measurements in the Intensive Care Unit (ICU). METHODS: Using the MIMIC-IV database (2008-2019), a single-center, academic referral hospital in Boston (USA), we identified adult patients meeting sepsis-3 criteria...
April 13, 2024: Journal of Biomedical Informatics
#30
JOURNAL ARTICLE
Margarita L Zuley, Jonathan Silverstein, Durwin Logue, Richard S Morgan, Rohit Bhargava, Priscilla F McAuliffe, Adam M Brufsky, Andriy I Bandos, Robert M Nishikawa
PURPOSE: In the United States, a comprehensive national breast cancer registry (CR) does not exist. Thus, care and coverage decisions are based on data from population subsets, other countries, or models. We report a prototype real-world research data mart to assess mortality, morbidity, and costs for breast cancer diagnosis and treatment. METHODS: With institutional review board approval and Health Insurance Portability and Accountability Act (HIPPA) compliance, a multidisciplinary clinical and research data warehouse (RDW) expert group curated demographic, risk, imaging, pathology, treatment, and outcome data from the electronic health records (EHR), radiology (RIS), and CR for patients having breast imaging and/or a diagnosis of breast cancer in our institution from January 1, 2004, to December 31, 2020...
April 2024: JCO Clinical Cancer Informatics
#31
JOURNAL ARTICLE
Meghan R Hutch, Jiyeon Son, Trang T Le, Chuan Hong, Xuan Wang, Zahra Shakeri Hossein Abad, Michele Morris, Alba Gutiérrez-Sacristán, Jeffrey G Klann, Anastasia Spiridou, Ashley Batugo, Riccardo Bellazzi, Vincent Benoit, Clara-Lea Bonzel, William A Bryant, Lorenzo Chiudinelli, Kelly Cho, Priyam Das, Tomás González González, David A Hanauer, Darren W Henderson, Yuk-Lam Ho, Ne Hooi Will Loh, Adeline Makoudjou, Simran Makwana, Alberto Malovini, Bertrand Moal, Danielle L Mowery, Antoine Neuraz, Malarkodi Jebathilagam Samayamuthu, Fernando J Sanz Vidorreta, Emily R Schriver, Petra Schubert, Jeffery Talbert, Amelia L M Tan, Byorn W L Tan, Bryce W Q Tan, Valentina Tibollo, Patric Tippman, Guillaume Verdy, William Yuan, Paul Avillach, Nils Gehlenborg, Gilbert S Omenn, Shyam Visweswaran, Tianxi Cai, Yuan Luo, Zongqi Xia
Few studies examining the patient outcomes of concurrent neurological manifestations during acute COVID-19 leveraged multinational cohorts of adults and children or distinguished between central and peripheral nervous system (CNS vs. PNS) involvement. Using a federated multinational network in which local clinicians and informatics experts curated the electronic health records data, we evaluated the risk of prolonged hospitalization and mortality in hospitalized COVID-19 patients from 21 healthcare systems across 7 countries...
April 2024: PLOS Digit Health
#32
JOURNAL ARTICLE
Jennifer A Hoffmann, Jacqueline B Corboy, Lynn Liu, Kristine Cieslak, Alba Pergjika, Tulsi R Patel, Naomi S Bardach, Elizabeth R Alpern
OBJECTIVES: Acute agitation during pediatric mental health emergency department (ED) visits presents safety risks to patients and staff. We previously convened multidisciplinary stakeholders who prioritized 20 proposed quality measures for pediatric acute agitation management. Our objectives were to assess feasibility of evaluating performance on these quality measures using electronic health record (EHR) data and to examine performance variation across 3 EDs. METHODS: At a children's hospital and 2 nonchildren's hospitals, we assessed feasibility of evaluating quality measures for pediatric acute agitation management using structured EHR data elements...
April 15, 2024: Hospital Pediatrics
#33
JOURNAL ARTICLE
Carmen Guzmán-Cornejo, Angel Herrera-Mares, Luis García-Prieto, Alejandro Oceguera-Figueroa, Andrés M López-Pérez, Karla Dzul-Rosado
Ehrlichia chaffeensis is a bacterium belonging to the Anaplasmataceae family. In Mexico, only 2 species have been recorded in association with tick species and humans. The objective of the present study was to detect the presence of bacteria of the genus Ehrlichia in ticks collected from the Chamela-Cuixmala Biosphere Reserve, Jalisco, Mexico. The collected ticks were identified and analyzed individually by polymerase chain reaction to amplify a fragment of the Anaplasmataceae 16S rRNA gene and the Ehrlichia-specific dsb gene...
April 14, 2024: Journal of Medical Entomology
#34
JOURNAL ARTICLE
Chao Yan, Henry H Ong, Monika E Grabowska, Matthew S Krantz, Wu-Chen Su, Alyson L Dickson, Josh F Peterson, QiPing Feng, Dan M Roden, C Michael Stein, V Eric Kerchberger, Bradley A Malin, Wei-Qi Wei
OBJECTIVES: Phenotyping is a core task in observational health research utilizing electronic health records (EHRs). Developing an accurate algorithm demands substantial input from domain experts, involving extensive literature review and evidence synthesis. This burdensome process limits scalability and delays knowledge discovery. We investigate the potential for leveraging large language models (LLMs) to enhance the efficiency of EHR phenotyping by generating high-quality algorithm drafts...
April 13, 2024: Journal of the American Medical Informatics Association: JAMIA
#35
JOURNAL ARTICLE
Ansh Bhatia, Renil Titus, Joao G Porto, Jonathan Katz, Diana Lopategui, Robert Marcovich, Dipen J Parekh, Hemendra Navinchandra Shah
INTRODUCTION: Natural Language Processing (NLP)-based data extraction from electronic health records (EHRs) holds significant potential to simplify clinical management and aid research. This review aims to evaluate the current landscape of NLP-based data extraction in prostate cancer (PCa) management. MATERIALS AND METHODS: We conducted a literature search of PubMed and Google Scholar databases using the keywords: "Natural Language Processing," "Prostate Cancer," "data extraction," and "EHR...
April 13, 2024: Journal of Endourology
#36
JOURNAL ARTICLE
Christian D Pulcini, Xianqun Luan, Elizabeth S Brooks, Annique Hogan, Tina Penrose, Chen C Kenyon, David M Rubin
Improving the overall care of children with medical complexity (CMC) is often beset by challenges in proactively identifying the population most in need of clinical management and quality improvement. The objective of the current study was to create a system to better capture longitudinal risk for sustained and elevated utilization across time using real-time electronic health record (EHR) data. A new Pediatric Population Management Classification (PPMC), drawn from visit diagnoses and continuity problem lists within the EHR of a tristate health system, was compared with an existing complex chronic conditions (CCC) system for agreement (with weighted κ) on identifying CCMC, as well as persistence of elevated charges and utilization from 2016 to 2019...
April 13, 2024: Population Health Management
#37
REVIEW
Nikolaos Tsaftaridis, Mark Goldin, Alex C Spyropoulos
Thromboprophylaxis of hospitalized patients at risk of venous thromboembolism (VTE) presents challenges owing to patient heterogeneity and lack of adoption of evidence-based methods. Intuitive practices for thromboprophylaxis have resulted in many patients being inappropriately prophylaxed. We conducted a narrative review summarizing system-wide thromboprophylaxis interventions in hospitalized patients. Multiple interventions for thromboprophylaxis have been tested, including multifaceted approaches such as national VTE prevention programs with audits, pre-printed order entry, passive alerts (either human or electronic), and more recently, the use of active clinical decision support (CDS) tools incorporated into electronic health records (EHRs)...
April 7, 2024: Journal of Clinical Medicine
#38
JOURNAL ARTICLE
Seoyeon Park, Junhyung Moon, Hoseon Eun, Jin-Hyuk Hong, Kyoungwoo Lee
Background : Patent ductus arteriosus (PDA) is a prevalent congenital heart defect in premature infants, associated with significant morbidity and mortality. Accurate and timely diagnosis of PDA is crucial, given the vulnerability of this population. Methods : We introduce an artificial intelligence (AI)-based PDA diagnostic support system designed to assist medical professionals in diagnosing PDA in premature infants. This study utilized electronic health record (EHR) data from 409 premature infants spanning a decade at Severance Children's Hospital...
April 3, 2024: Journal of Clinical Medicine
#39
JOURNAL ARTICLE
Shannon Reidt, Mark Hsieh, Joud Roufael, Sharon Kim, Geeta Panwalkar, Max Sow
BACKGROUND: Pharmacists have some prescriptive authority in all fifty states through dependent and independent prescribing. Data describing the volume and characteristics of pharmacist prescribing are not widely available, and these insights are critical to gauge the impact of regulations supporting pharmacist prescriptive authority. OBJECTIVE: To identify trends in pharmacist prescribing and compare them to primary care provider (PCP) prescribing trends by analyzing e-prescriptions initiated from electronic health records systems (EHRs) from 2019 through 2022...
April 10, 2024: Journal of the American Pharmacists Association: JAPhA
#40
JOURNAL ARTICLE
Tammy Walkner, Daniel W Karr, Sarah Murray, Amanda Heeren, Maresi Berry-Stoelzle
BACKGROUND: Many of the challenges in advanced care planning (ACP) conversations are linked to the waxing and waning progress of serious illnesses. Conversations with patients about future medical care decisions by a surrogate decision maker have historically been left until late in the patient's disease trajectory. These conversations often happen at a time when the patient is already very ill. The challenge in effective early ACP and serious illness conversations is to create a situation where patients appreciate the link between current and future medical care...
April 12, 2024: JMIR Research Protocols
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