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Clinical Decision System

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https://www.readbyqxmd.com/read/28231636/personalized-thromboprophylaxis-using-a-risk-score-for-the-management-of-pregnancies-with-high-risk-of-thrombosis-a-prospective-clinical-study
#1
Y Dargaud, L Rugeri, C Fleury, C Battie, P Gaucherand, C Huissoud, R C Rudigoz, H Desmurs-Clavel, J Ninet, M C Trzeciak
BACKGROUND: Patients with thrombophilia and/or a history of venous thromboembolism (VTE) are at risk of thrombosis during pregnancy. A risk score for pregnancies with increased risk of VTE was previously described by our group (Lyon-VTE-score). OBJECTIVES: The aim of this prospective study was to assess the efficacy and safety of our score-based prophylaxis strategy in 542 pregnancies managed between 2005 and 2015 in Lyon University Hospitals. PATIENTS/METHODS: Of 445 patients included in the study, 36 had several pregnancies during the study period...
February 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28231425/practice-patterns-regarding-multidisciplinary-cancer-management-and-suggestions-for-further-refinement-results-from-a-national-survey-in-korea
#2
Yun-Gyoo Lee, Sukjoong Oh, Heejin Kimm, Dong-Hoe Koo, Do Yeun Kim, Bong-Seog Kim, Seung-Sei Lee
Purpose: This study was conducted to explore the process and operation of a cancer multidisciplinary team (MDT) after the reimbursement decision in Korea, and to identify ways to overcome the major barriers to effective and sustainable MDTs. Materials and Methods: Approximately 1000 cancer specialists, including medical oncologists, surgical oncologists, radiation oncologists, pathologists, and radiologists in general hospitals in Korea were invited to complete the survey...
February 22, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28231045/original-research-paper-public-health-care-system-a-quasi-experimental-study-acceptance-and-attitude-to-implicate-clinical-services
#3
Syed Wasif Gillani, Mohi Iqbal Mohammad Abdul
A six-month longitudinal intervention arm study with a pre-post cross-sectional questionnaire-based survey was performed. A 3-phase objective structured clinical examination (OSCE) design was utilized for evaluation of acceptance and attitude of pharmacy students towards clinical pharmacy services. The pre-OSCE survey showed increased disagreement with the role of clinical pharmacists, compared to a significant positive shift in attitude towards their services in the healthcare team after 6 months of the trial...
March 1, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28229254/the-impact-of-post-procedural-complications-on-reimbursement-length-of-stay-and-mechanical-ventilation-among-patients-undergoing-transcatheter-aortic-valve-implantation-in-germany
#4
Klaus Kaier, Holger Reinecke, Huseyin Naci, Lutz Frankenstein, Martin Bode, Werner Vach, Philip Hehn, Andreas Zirlik, Manfred Zehender, Jochen Reinöhl
BACKGROUND: The impact of various post-procedural complications after transcatheter aortic valve implantation (TAVI) on resource use and their consequences in the German reimbursement system has still not been properly quantified. METHODS: In a retrospective observational study, we use data from the German DRG statistic on patient characteristics and in-hospital outcomes of all isolated TAVI procedures in 2013 (N = 9147). The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation was analyzed using both unadjusted and risk-adjusted linear and logistic regression analyses...
February 22, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28227784/an-analytics-based-clinical-decision-support-system-for-cvd-risk-assessment-and-management
#5
Shreya Anand, Ravindra B Patil, P Krishnamoorthy, Shreya Anand, Ravindra B Patil, P Krishnamoorthy, Shreya Anand, Ravindra B Patil, P Krishnamoorthy
Cardiovascular disease (CVD) is a major cause of disability and premature death throughout the world. Acute coronary events and other cardiovascular events frequently occur suddenly, and are often fatal before medical care can be given. Risk factor modification can reduce clinical events and premature death in people with established cardiovascular disease as well as in those who are at high cardiovascular risk due to one or more risk factors. In this work, India specific World Health Organization-International Society of Hypertension (WHO-ISH) guidelines has been implemented to stratify the subjects by their risk profile...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227781/measuring-the-intuitive-response-of-users-when-faced-with-different-interactive-paradigms-to-control-a-gastroenterology-cad-system
#6
D Abrantes, P Gomes, D Pereira, M Coimbra, D Abrantes, P Gomes, D Pereira, M Coimbra, D Pereira, D Abrantes, P Gomes, M Coimbra
The gastroenterology specialty could benefit from the introduction of Computer Assisted Decision (CAD) systems, since gastric cancer is a serious concern in which an accurate and early diagnosis usually leads to a good prognosis. Still, the way doctors interact with these systems is very important because it will often determine its embracement or rejection, as any gains in productivity will frequently hinge on how comfortable they are with it. Using other types of interaction paradigms such as voice and motion control, is important in a way that typical inputs such as keyboard and mouse are sometimes not the best choice for certain clinical scenarios...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227143/csdc-a-nationwide-screening-platform-for-stroke-control-and-prevention-in-china
#7
Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao, Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao, Dan Ye, Huajian Mao, Mei Li, Dongsheng Zhao, Jinghui Yu
As a leading cause of severe disability and death, stroke places an enormous burden on Chinese society. A nationwide stroke screening platform called CSDC (China Stoke Data Center) has been built to support the national stroke prevention program and stroke clinical research since 2011. This platform is composed of a data integration system and a big data analysis system. The data integration system is used to collect information on risk factors, diagnosis history, treatment, and sociodemographic characteristics and stroke patients' EMR...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227048/anticoagulation-manager-development-of-a-clinical-decision-support-mobile-application-for-management-of-anticoagulants
#8
Chih-Wen Cheng, Hang Wu, Pamela J Thompson, Julie R Taylor, Barbara A Zehnbauer, Karlyn K Wilson, May D Wang, Chih-Wen Cheng, Hang Wu, Pamela J Thompson, Julie R Taylor, Barbara A Zehnbauer, Karlyn K Wilson, May D Wang, Karlyn K Wilson, Pamela J Thompson, Barbara A Zehnbauer, Hang Wu, Julie R Taylor, Chih-Wen Cheng, May D Wang
Patients with certain clotting disorders or conditions have a greater risk of developing arterial or venous clots and downstream embolisms, strokes, and arterial insufficiency. These patients need prescription anticoagulant drugs to reduce the possibility of clot formation. However, historically, the clinical decision making workflow in determining the correct type and dosage of anticoagulant(s) is part science and part art. To address this problem, we developed Anticoagulation Manager, an intelligent clinical decision workflow management system on iOS-based mobile devices to help clinicians effectively choose the most appropriate and helpful follow-up clotting tests for patients with a common clotting profile...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227033/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#9
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Mohamed Rehman, Ali Jalali, Vinay Nadkanri, Dieter Bender, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227009/a-machine-learning-framework-for-auto-classification-of-imaging-system-exams-in-hospital-setting-for-utilization-optimization
#10
Meru A Patil, Ravindra B Patil, P Krishnamoorthy, Jacob John, Meru A Patil, Ravindra B Patil, P Krishnamoorthy, Jacob John, Meru A Patil, Jacob John, Ravindra B Patil, P Krishnamoorthy
In clinical environment, Interventional X-Ray (IXR) system is used on various anatomies and for various types of the procedures. It is important to classify correctly each exam of IXR system into respective procedures and/or assign to correct anatomy. This classification enhances productivity of the system in terms of better scheduling of the Cath lab, also provides means to perform device usage/revenue forecast of the system by hospital management and focus on targeted treatment planning for a disease/anatomy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226971/personalized-sleep-staging-system-using-evolutionary-algorithm-and-symbolic-fusion
#11
Chen Chen, Adrien Ugon, Xun Zhang, Amara Amara, Patrick Garda, Jean-Gabriel Ganascia, Carole Philippe, Andrea Pinna, Chen Chen, Adrien Ugon, Xun Zhang, Amara Amara, Patrick Garda, Jean-Gabriel Ganascia, Carole Philippe, Andrea Pinna, Adrien Ugon, Carole Philippe, Patrick Garda, Amara Amara, Chen Chen, Andrea Pinna, Jean-Gabriel Ganascia, Xun Zhang
This paper presents a novel system for automatic sleep staging based on evolutionary technique and symbolic intelligence. Proposed system mimics decision making process of clinical sleep staging using Symbolic Fusion and considers personal singularity with an adaptive thresholds setting up system using Evolutionary Algorithm. It proved to be an effective and promising system in personalizing sleep staging. This system can also be integrated with other medical systems to realize remote sleep monitoring or home-care...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226948/automated-feet-detection-for-clinical-gait-assessment
#12
Miguel M Serrano, Yu-Ping Chen, Ayanna Howard, Patricio A Vela, Miguel M Serrano, Yu-Ping Chen, Ayanna Howard, Patricio A Vela, Miguel M Serrano, Ayanna Howard, Patricio A Vela, Yu-Ping Chen
The paper describes a computer vision method for estimating the clinical gait metrics of walking patients in unconstrained environments. The method employs background subtraction to produce a silhouette of the subject and a randomized decision forest to detect their feet. Given the feet detections, the stride and step length, cadence, and walking speed are estimated. Validation of the system is presented through an error analysis on manually annotated videos of subjects walking in different outdoor settings...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226351/-significance-and-contemplation-of-clinical-diagnosis-and-therapy-on-the-renewal-of-the-eighth-edition-of-gastric-cancer-tnm-staging-system
#13
Hongqing Xi, Kecheng Zhang, Bo Wei, Lin Chen
TNM staging is essential for clinical decision-making and prognostic prediction for patients with gastric cancer. The 7th TNM staging manual was formulated in 2009 and implemented in 2010. However, it was published that there were some deficiencies of the 7th edition of gastric cancer TNM staging system in clinical application process, and this old staging system could not meet the clinical needs. With the cooperation and promotion of the American Joint Committee on Cancer (AJCC), the International Union for Cancer Control (UICC) and the International Gastric Cancer Association (IGCA), and through the accumulation and analysis of gastric cancer big data, the 8th TNM staging system was published at the end of 2016...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#14
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225511/treatment-satisfaction-in-systemic-lupus-erythematosus-development-of-a-patient-reported-outcome-measure
#15
Susan D Mathias, Pamela Berry, Katie Pascoe, Jane de Vries, Anca D Askanase, Hilary H Colwell, David J Chang
OBJECTIVE: The aim of this study was to develop a patient-reported outcome measure specific for systemic lupus erythematosus (SLE) to assess patient satisfaction with treatment, treatment options, and medical care. METHODS: Patients with SLE were recruited from four US rheumatology practices. Concept elicitation interviews identified aspects that patients considered important and relevant regarding satisfaction with treatment and medical care. Concept elicitation interviews and clinical input were used to draft the Lupus Satisfaction Questionnaire (LSQ)...
March 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28224645/clinical-decision-support-systems-differ-in-their-ability-to-identify-clinically-relevant-drug-interactions-of-immunosuppressants-in-kidney-transplant-patients
#16
J Amkreutz, A Koch, L Buendgens, C Trautwein, A Eisert
WHAT IS KNOWN AND OBJECTIVE: In kidney transplant patients, clinically relevant drug-drug interactions (DDIs) with immunosuppressants potentially lead to serious adverse drug events (ADEs). The aim of this study was (i) to show that five clinical decision support systems (CDSSs) differ in their ability to identify clinically relevant potential DDIs (pDDIs) of immunosuppressants in kidney transplant patients and (ii) to compare CDSSs in terms of their ability to identify clinically relevant pDDIs in this context...
February 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28224371/can-disproportionality-analysis-of-post-marketing-case-reports-be-used-for-comparison-of-drug-safety-profiles
#17
Christiane Michel, Emil Scosyrev, Michael Petrin, Robert Schmouder
Clinical trials usually do not have the power to detect rare adverse drug reactions. Spontaneous adverse reaction reports as for example available in post-marketing safety databases such as the FDA Adverse Event Reporting System (FAERS) are therefore a valuable source of information to detect new safety signals early. To screen such large data-volumes for safety signals, data-mining algorithms based on the concept of disproportionality have been developed. Because disproportionality analysis is based on spontaneous reports submitted for a large number of drugs and adverse event types, one might consider using these data to compare safety profiles across drugs...
February 21, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28224190/what-is-a-periprosthetic-shoulder-infection-a-systematic-review-of-two-decades-of-publications
#18
REVIEW
Jason E Hsu, Jeremy S Somerson, Kiet V Vo, Frederick A Matsen
PURPOSE: While as many as 50% of revision shoulder arthroplasties are culture positive, a consistent, clinically useful definition of a "periprosthetic shoulder infection" is lacking. We conducted a systematic review of the published literature with respect to (1) the definition of a "periprosthetic shoulder infection", (2) the pre-operative evaluation for possible infection, and (3) the harvesting and culturing of specimens at the time of surgical revision. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 20 studies concerning infection at the time of revision shoulder arthroplasty...
February 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28224048/wound-penetration-of-cefazolin-ciprofloxacin-piperacillin-tazobactam-and-vancomycin-during-negative-pressure-wound-therapy
#19
Matthew P Rowan, Krista L Niece, Julie A Rizzo, Kevin S Akers
Objective: Negative pressure wound therapy (NPWT) uses subatmospheric pressure as a noninvasive adjunct to treat wounds and has demonstrated clinical efficacy by accelerating healing of a variety of acute and chronic wounds. NPWT may also play a role in preventing or treating wound infections, possibly by increasing wound penetration of antibiotics. However, clinical data in patients undergoing antibiotic and NPWT treatment are limited. Approach: To evaluate the wound penetration of antibiotics in NPWT patients, we conducted a prospective, observational study of burn and trauma patients treated with NPWT and systemic antibiotics...
February 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28224029/designing-clinical-and-genetic-guidelines-of-colorectal-cancer-screening-as-an-effective-roadmap-for-risk-management
#20
Mohammad Reza Zali, Reza Safdari, Elham Maserat, Hamid Asadzadeh Aghdaei
AIM: We aimed to present clinical and genetic guidelines of colorectal cancer screening for risk assessment of populations at risk. BACKGROUND: National guidelines can be used as a guide for choosing the method of screening for each individual. These guidelines facilitate decision making and support the delivery of cancer screening service. METHODS: In the first step, a comparative study was performed by using secondary data extracted from the literature review...
December 2016: Gastroenterology and Hepatology From Bed to Bench
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